A routine physical examination ensures that you stay in good health. A physical can also be a preventive step. It allows you to catch up on vaccinations or detect a serious condition, like cancer or diabetes, before it causes problems. During a routine physical, your doctor can also check vitals, including weight, heart rate, and blood pressure.
What does a physical exam address?
Your doctor will use a physical exam to see how your body is performing. Depending on your personal health history, your doctor may choose to focus on certain areas. If you have a family history of heart disease, for example, you may receive additional blood pressure checks, blood tests, and diabetes and cholesterol screenings.
Based on test results, age, and personal health history, the exam is also an opportunity to discuss future prevention measures with your doctor.
What does a physical exam entail?
An average physical exam may include the following:
Updated health history
Your doctor may ask for an update on new developments and changes in your health history. This may include questions about your job and relationships, medications, allergies, supplements, or any recent surgeries.
Vital sign checks
This includes taking a blood pressure reading and checking your heart rate and respiratory rate. Your blood pressure should be checked at least once every year to once every three years, depending on your history.
Your doctor will review your appearance for signs of any potential conditions. They’ll check the parts of your body that could visually indicate any existing health issues. This includes examining the following:
- musculoskeletal system, such as your hands and wrists
- nervous system functions, such as speech and walking
As the physical exam continues, the doctor will use tools to look in your eyes, ears, nose, and throat. They’ll listen to your heart and lungs. This exam also includes:
- touching, or “palpating,” parts of your body (like your abdomen) to feel for abnormalities
- checking skin, hair, and nails
- possibly examining your genitalia and rectum
- testing your motor functions and reflexes
To complete the physical, your doctor may draw blood for several laboratory tests. These can include a complete blood count and a complete metabolic panel (also called a chemistry panel). The panel tests your blood plasma and can indicate any issues that exist in your kidneys, liver, blood chemistry, and immune system. This helps detect irregularities in your body that might indicate a larger problem. Your doctor may request a diabetes screen and a thyroid screen. If you have an increased risk of heart attack, heart disease, or stroke, they may also request a lipid panel (cholesterol test).
What screening tests might be performed?
Your doctor might request screening tests. These can differ based on your biological sex.
- Mammogram: In women with low or average risk for breast cancer, a mammogram is recommended every two years between the ages of 50 and 74. Earlier and more frequent testing may be recommended based on your personal history and family history of breast cancer.
- Breast exam: A breast exam can be used to check for abnormal lumps or signs of breast cancer.
- Pap smear: The pap smear is a screening for cervical cancer. Women should begin screening at age 21. After that, subsequent screenings are recommended every three years, as long as the woman has a healthy immune system. After 30 years old, pap smears are recommended once every five years, until the age of 65. After age 65, the majority of women no longer require a pap smear.
- Pelvic exam: This can be done with or without a pap smear. A pelvic exam includes examining the vagina, cervix, and vulva for signs of a sexually transmitted infection (STI) or other conditions.
- Cholesterol test: Most women should begin regular cholesterol checks at age 45. If you have a history of or genetic predisposition to diabetes or heart disease, you may need to begin cholesterol checks as early as age 20.
- Osteoporosis screening: Bone density scans should begin around age 65. They may begin sooner in certain medical conditions.
- Cholesterol test: Most men are advised to begin regular cholesterol checks at age 35. If you have a history of or genetic predisposition to diabetes or heart disease, you may need to begin cholesterol checks as early as age 20.
- Prostate cancer screening: In general, using the prostate-specific antigen test and digital rectal exam for prostate cancer screening is not recommended, so talk to your doctor. Screening may be advised for some men starting at age 50. It may start as early as age 40 for those with a strong family history.
- Testicular exam: Your doctor may wish to check each testicle for signs of a problem, including lumps, changes in size, and tenderness.
- Abdominal Aortic Aneurysm screening: This is a one-time screening test done with an ultrasound. It is recommended for all men ages 65-75 who have ever smoked.
Both men and women:
- Colon (colorectal) cancer test: Tests for this cancer usually begin at age 50. It may be sooner based on personal health conditions and family history.
- Lung cancer screening: An annual low-dose CT scan of the lungs is recommended for both men and women ages 55-80 who have smoked for a significant period of time or who are currently smoking. Talk to your doctor to see if your smoking history warrants a lung cancer screen.
- Depression: Many people aren’t aware of possible symptoms of depression because they can be easily attributed to other things. However, a depression screening at each checkup can help your doctor to see if your symptoms are a result of depression.
- Diabetes: If you have a family history or risk factors for diabetes — such as being overweight or having high blood pressure or high cholesterol — you should be screened for diabetes. Your doctor may use the fasting blood sugar test or the A1C test.
- Hepatitis C: All individuals born between 1945 and 1965 are recommended to have a one-time blood test to screen for hepatitis C.
- Vaccinations: All adults continue to need vaccinations throughout their lifetime. Talk to your doctor about which vaccinations are recommended based on your age.
- STI screening: Based on your personal sexual history, regular STI screenings during each routine physical exam may be suggested. This can include HIV and syphilis testing.
- HIV test: Your doctor may recommend taking a one-time HIV test for preventive purposes, or having it done more than once if you regularly have unprotected sex.
- Syphilis test: You may need to take this test if you’re pregnant or at risk for syphilis.
If your doctor believes that a specific part of your body requires closer examination, you may receive what’s known as a focused physical exam. In this type of exam, your doctor may only look at a certain part of your body to confirm their suspected diagnosis.
Where and how will the exam be administered?
Most full physical exams are performed during a routine physical in a doctor’s office. When additional screenings or imaging tests are recommended, they may be completed at an imaging center or hospital. Blood test draws can be performed at the doctor’s office before samples are sent to a lab for analysis.
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What are the risks of the test?
Most portions of a physical exam carry no risks. Some mild discomfort and pain might occur during a blood test when the needle is inserted into the vein for blood withdrawal. A small bruise may also develop where the needle was inserted after it’s removed. This bruise should heal in a few days.
While a physical exam is considered by many to be a great way to develop an overall picture of a person’s health, some experts are not convinced that it’s necessary every year. Some abnormal test results may cause unnecessary worry. Talk to your doctor about the best interval for your routine health exam.
How do you prepare for the test?
You don’t need to prepare for a physical exam unless your doctor requests a fast for a fasting blood test.
Before you go to your test, however, take note of:
- anything you’re allergic to
- your current medications
- your symptoms, in case you’ve noticed any health issues
- any recent lab test results
- any device cards, if you have a pacemaker or other similar device
- the names, phone numbers, and addresses of any doctors or specialists you’re currently seeing
You should prepare some questions to ask your doctor, such as:
- What screening tests are recommended for my age?
- Which vaccines do I need?
- Is there anything in my family history that puts me at risk for certain health conditions?
- What changes can I make in my routine to improve my health?
You should also be prepared to answer some of your doctor’s questions, including:
- How often do you exercise?
- Do you smoke, drink alcohol, or use any drugs?
- What is your diet like?
- Are you feeling any abnormal pain or discomfort?
- Where do you feel the pain or discomfort?
- How is your sleep?
Your doctor may request a return visit to discuss test results or follow up on any exam findings. The physical exam is a chance for a frank discussion about health, habits, and your future. With your doctor’s help, you’ll be able to tackle signs of potential problems with a plan.
Routine physicals, especially as you get older, can prevent many potential health issues. They can also help you prepare for any issues that you may be at risk for due to aging, your family history, or lifestyle. Communicating with your doctor at each physical can help you learn more about your body and what you need to do to stay at your healthiest.