Tuesday, August 19, 2014

What your annual physical should have been all along

More and more policy makers in the medical field are saying that the annual physical should be a thing of the past for most healthy people. (See this story in the Washington Post.) While GP's may miss the revenue, many will be relieved that they won't get barraged by a collection of issues the patient has stored up over the year. For doctors think the physical is only physical! They want to take your blood pressure, steal some blood, do a couple tests. If you bring up something else, your doc might look at you politely but he or she is thinking, "You should make an appointment for that."
Courtesy Stock Images, Freedigital photo
I think these two views--that you don't need to run these tests every year and the physical is just to run a few tests--completely miss the opportunity! We should still have an annual meeting with our doctors but it should be for what we, the patients, always thought it was: to review our overall health.

Throughout the year, you have issues that come up that don't seem urgent enough to warrant a special visit to the medical clinic. Maybe you notice you're getting headaches more often or having trouble losing weight or are about to split in two with the demands on your time. There's that clicking noise in your knee and a spot on your back that you're not sure you should be concerned about. When are you supposed to bring up those issues?

Doctors should continue to call us into their office once a year, but it should be more of a holistic conversation about your well-being: How's life? What worries you? Where do you experience pain? What are you eating and how much sleep are you getting?

Our medical system only seems to treat symptoms. If you have an urgent or painful situation, you go in but the doctors usually only address that problem. But they rarely ask how it might be related to other less urgent symptoms.

For years, I complained about pain in one part of my body or another, based on what hurt the most: my knee, my back, my shoulder, my neck. I would be offered pain relievers and sent on my way. But it was only by accident (actually a bike accident) that a doctor bothered to notice how I moved and discovered I had one leg half an inch shorter than the other. I was slowly becoming crippled. No doctor before ever asked, "Where else do you hurt?" so they could discover it was all on one side of  my body and a simple problem with body mechanics, not the natural effects of aging. The osteopath gave me a lift for my shoes and now most of my pain is gone.

Having been through this, I can identify people on the street who have a short leg. If I can do it, why can't every GP? So much pain comes from years of untreated problems of body mechanics. Shouldn't this be part of the physical too? Test my balance, strength and flexibility.

The so-called physical should be mental too. The mind-body connection fluidly sends symptoms in both directions. Anger and stress can lead to stomach aches and head aches; and pain can make you angry and stressed.

So doctors, fine, eliminate the physical. But replace it with an annual a holistic health assessment. That's what we thought it was all along!