Photo: Gage Skidmore | Flickr
Want to know if the president is healthy? Don’t expect to learn much from his medical examination today.
President Trump is expected to undergo his first physical amid increased speculation about his health.
This is due in part to the fact that he ascended to the presidency at age 70, making him the oldest person to ever be voted into office. Additionally, his eating habits reportedly include plenty of fast food.
Some mental health experts have also called for an assessment of his cognitive health. Some experts even visited Capitol Hill to talk to lawmakers about their concerns.
About the president’s physical
But those hoping for answers, they may not learn much from the president’s annual physical.
First, it’s important to note that the president isn’t required to undergo a medical exam.
Additionally, the president’s medical information is protected by federal law. As a result, Trump isn’t required to share any medical information with the public.
Trump is expected to be examined by Dr. Ronny Jackson, a physician to the president who also performed physicals on former President Barack Obama.
Even if Jackson diagnoses a condition or illness, Trump has the right to keep this information from becoming public, like any other citizen.
When President Obama underwent a physical, Jackson released the results with Obama’s consent. The results included some vital statistics, including Obama’s age, weight, height, and heart rate.
The physical examination included an eye exam, a check of the ears, nose, throat, lungs, skin, heart function, and gastrointestinal system, among other things.
He also released some lab results of the president, including his levels of cholesterol, blood glucose, vitamin D, and prostate-specific antigen, or PSA test.
Trump’s exam will likely follow a similar pattern.
Dr. Tochi Iroku-Malize, chair for family medicine at Northwell Health in New York, said the main components of a physical involve the basics of getting a patient’s height, weight, body mass index, and blood pressure, as well as listening to the lungs and heart.
“What a lot of people don’t realize is that those are the main things that we check,” she said. “Those are the main components, then you continue your exam further based on the history of the risk factors or whatever medical conditions the patient has.”
Iroku-Malize said that the physician would also take a detailed history, and then decide if more testing was needed.
Dr. Barbara Keber, vice chair for family medicine at Northwell Health, explained that this history is key to understanding a patient’s overall health.
We’ll check “what their lifestyle habits are, which is very important in looking for chronic diseases,” she said.
For example, if a patient is overweight, not eating a healthy diet, and not exercising, a physician might order further blood work to check for cholesterol levels, signs of diabetes, and other indicators of a cardiac disease.
What doctors are looking for
Dr. Priyanka Wali, a California-based physician who’s board-certified in internal medicine and obesity medicine, said she was concerned after seeing some lab results that President Trump’s former physician released at the end of 2015.
According to that letter, Trump was overweight, although just shy of being obese, and had a calcium score of 98 in 2013.
Wali said that if that score has increased, it could indicate Trump has plaque building up in his arteries, which would put him at risk of cardiovascular disease.
Additionally, she said that she’d want testing done to see Trump’s blood insulin levels and do a blood test that could indicate if the president has prediabetes.
Wali pointed out that diabetes can affect more than physical health. It could also impact cognitive health.
“He needs to be screened for diabetes absolutely,” she said. “If he has diabetes, that can affect your brain, that can cause vascular dementia.”
However, for people concerned about the president’s cognitive health, a physical doesn’t focus much on neurological status.
Keber said physicians will screen for mental health conditions such as depression but not cognitive decline, unless the patient or family member brings up concerns.
“One of the things that we do now in primary care is an annual screening for depression, and we also do some screens for other things like anxiety or other things like alcohol use or drug use,” she said.
Keber said that in a normal physical, a physician may not check a patient’s cognitive function unless the patient brought up memory lapses or other issues that could indicate a neurological decline.
“We would only go further with a cognitive exam if there is a complaint or if you observe the patient has a cognitive” problem, she said.
Dr. Roy Buchinsky, an internal medicine physician and director of corporate health and executive wellness at University Hospitals Cleveland Medical Center, said there are cognitive tests that a general practitioner can perform, such as asking a patient to draw a clock or asking them a few questions.
But these tests may not catch everything.
“It’s hard to screen for Alzheimer’s at the early stages,” Buchinsky said.
Buchinsky said he wouldn’t be surprised if the president also underwent an electrocardiogram and stress test on a treadmill to determine his cardiovascular health.
Most patients over age 65 would also be advised to get certain vaccinations if they haven’t already. Those include pneumonia, shingles, and flu vaccinations.
Buchinsky said all of these exams and tests can be doubly important for a president.
As he pointed out, “It’s been shown that people age twice as quickly when you’re in the president’s office.”