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Q
Are Routine Physical Exams Necessary?

What should a complete physical exam include? And how often should you have one?

A
Answer (Published 9/6/2010)

I don't necessarily recommend an annual physical exam for everyone, but if you've never had a complete physical, I do suggest that you schedule one.

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I believe that a comprehensive medical exam should include a thorough history that details your current health status, any symptoms that concern you, previous illnesses, medical tests you've had in the past (with results, if they're available); medications you're taking (be sure to note the dosages of any prescription drugs and mention any over-the-counter drugs, vitamins and dietary supplements you take regularly); a description of any allergies you may have; and the health problems of your parents, siblings, spouse and children, if you have them. You should be asked if you smoke or ever did, whether you drink alcohol and, if so, how much, and if you take any recreational drugs. This information is necessary to allow your health care provider to assess your risks of disease, and suggest the most important preventive strategies you should follow. It can also make it easier for you and others to track changes in your health over time, and help you avoid unnecessary medical tests and procedures. Create a file for your personal health history and keep it up to date.

The actual physical examination should include measurement of your temperature, height, weight, pulse rate, and blood pressure. The physician should also measure your waist circumference, listen to your heart and lungs, and examine your body, including a good look at your skin for any signs of skin cancer. Men over 40 should have a digital rectal exam to check the size and texture of the prostate; women who have ever had sex should have an annual pelvic exam with Pap smear to screen for cervical cancer. Ask your doctor to record your body mass index (BMI), a number calculated from your height and weight that may indicate excessive body fat and screens for weight categories that might be associated with future health problems.

As long as you're healthy, you may not need a physical exam more often than every five years. But if you have any chronic health problem or a strong family history of heart disease, cancer, or other conditions, or if your lifestyle choices have not been health promoting, you should be examined more frequently. That means every two years if you have a chronic health problem or if your diet and level of physical activity put you at risk. I suggest an annual physical only if you have a strong family history of heart disease or cancer or if you worry a lot about getting either disease. Be sure to see the doctor whenever there's a change in your health status or if you develop new symptoms. (By the way, a clean bill of health from a recent complete physical may help you get health insurance at a reduced premium.)

Andrew Weil, M.D.

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