Caitlin Whyte (Host): Welcome to Hally HealthCast, the wellness podcast from Hally Health, your partner in helping you live your healthiest life. Every episode on our podcast addresses a new topic important to your health and well-being, bringing in doctors, specialists, and other health experts to who offer advice and answer your most pressing questions.

Today's episode is all about the importance of an annual physical. August is back to school time when many of our youngsters may need to get their annual physical exam for school or athletic participation, so it's the perfect time to learn more about this important topic.

Here with us is Serena Curler. She is an Advanced Practice Registered Nurse working in Population Health Services at Carle Health. Welcome, Ms. Curler, and thank you so much for being with us today and sharing your knowledge and experience.

Well, whether you're a back to school age youngster or a retiree on Medicare or anywhere in between, it's important to get checked out regularly by your primary care provider. And that means an annual physical exam for students and adults, and an annual wellness visit or AWV for older adults. So, Ms. Curler, what's the difference between a physical and an AWV, and what can we expect at either one?

Serena Curler: An annual physical involves a head-to-toe physical exam for early detection of disease or health concerns. It is for patients of all ages. An annual wellness visit, or AWV, focuses on health risks. It is all about prevention and covered screenings for Medicare patients. Some screenings involve questions such as cognitive screening or depression screening, and other tests such as a bone density scan. The patient's medical history is reviewed. Important topics to this population are discussed, such as having a power of attorney for healthcare, social determinants of health, and home safety. Recommendations range from preventing disease to treating disease. At an annual wellness visit, the nurse does much of the interview, vital signs are checked, and the provider may or may not do a physical exam. The provider signs any orders relating to screenings or immunizations.

Host: Awesome answer, Ms. Curler. Thank you so much for making that so easy to understand. But here's something I'm not sure even I understand so well, an IPPE or initial preventative physical exam. Ms. Curler, what is that exactly, and why would a person need one of those?

Serena Curler: An IPPE is for Medicare Part B and Part C patients. It is a once in a lifetime initial physical when first enrolling in Medicare. It is like an annual wellness visit. Like the annual wellness visit, health screenings and health risks are the focus of the visit. Lab work or testing that is ordered is for screening for disease rather than treating or monitoring disease.

Host: Gotcha. Well, thank you, Ms. Curler, that doesn't sound nearly as intimidating as the name. Well, here's another serious-sounding term, a health risk assessment. What is that, Ms. Curler? And how does it differ from an annual wellness visit then?

Serena Curler: A health risk assessment, or HRA, is a visit with a Health Alliance Carle Population Health nurse practitioner. It is for eligible Medicare Advantage and commercial members at no cost to the member. It is very similar to an annual wellness visit, and it is basically an extra set of eyes for members' healthcar needs. It is designed to support both Carle and non-Carle Health Alliance members. It is a similar discussion to the annual wellness visit regarding the patient's medical history, medications, overall health status, home safety, and health education. Sometimes needs are identified in which the nurse practitioner would place an order or referral. This helps to fill gaps in care. The NPs are available for local members at Carle on Curtis, or virtually for members throughout Illinois, Iowa, and Indiana. An HRA involves fewer health screenings than an annual wellness visit, but it does not replace an annual wellness visit.

Host: Well, thank you for making that a whole lot clearer, Ms. Curler. Let's talk a bit more about the annual wellness visit. What do you need to know going in for one? How can you prepare for an AWV?

Serena Curler: An annual wellness visit for Medicare members at the primary care provider's office involves a detailed health discussion, a review of their medical history, health screenings, immunizations, and possibly a brief exam. It includes screenings that Carle Population Health nurse practitioners don't do, such as cognitive screening, a functional mobility test, and checking vital signs. Patients can prepare for the visit by bringing medical records, immunization records, their medication and supplements, a list of their providers or medical suppliers. More and more, I see patients access this info on their smartphone if they use apps to access their charts.

Host: Wonderful. Thank you, Ms. Curler. That was super helpful. Well, we've covered physical exams and annual wellness visits from just about every angle, except one, and that's the subject of this episode, the importance of an annual physical exam or wellness visit. Now, if you're a parent or guardian or a student, you already know it's important. It's required, but what about the rest of us? Ms. Curler, how important is it for people, no matter how old they are, to schedule an annual physical or wellness visit with their primary care provider?

Serena Curler: Benjamin Franklin once said an ounce of prevention is worth a pound of cure. In other words, an annual physical exam and wellness discussion may detect problems before symptoms occur. The healthcare providers determine what patients are most at risk for given their age and health status.

When I worked in a presurgical evaluation clinic, I would examine and interview patients prior to surgery. What I did is not different than what your primary care provider can do. I determined one patient to be highly suspicious for diabetes and ordered an A1c screening test on her, which resulted in diagnosing her diabetes. Damage to the body's organ systems can be prevented when diagnosed earlier rather than later. I also had another patient that told me he had a heart murmur all his life, but it was never investigated. An ultrasound that I ordered revealed narrowing of the aortic valve, also called aortic stenosis. I was able to get him into the cardiologist who counseled him on the results, what symptoms to expect should it worsen, and he was set up with regular monitoring. With further cardiology evaluation, it was determined that he could safely proceed to surgery. For younger patients that want to engage in sports, who may not have any symptoms even with activity, if a heart murmur is detected on exam, it should be evaluated to determine if it is normal as a young person or if it is abnormal and could cause sudden death.

Host: Wow. Well, if that doesn't convince you to see the doctor, I don't know what will. Terrific wrap up, Ms. Curler. You've been an absolute pleasure to have on our podcast. Thank you so much for joining us and for all that you do every day at Carle Health for so many people and families.

That concludes today's Hally HealthCast. Tune in next time as we tackle yet another topic important for your health and well being. And remember, Hally Health is your partner in helping you live your healthiest life. Visit hally.com. That's H-A-L-L-Y.com for resources, information, tips, and much more. Let us help keep you and your family healthy and well. Thanks for listening. We hope you tune in again.