Joey Wahler (Host): They are key to prevention, so we're discussing annual physicals. Our guest is Dr. Michael Davidson. He's a family medicine physician. This is Silver Cross Hospital's iMatter Health Podcast, where medical experts bring you the latest information on health topics mattering most to you and your family, brought to you by the Village of New Lenox. Thanks for joining us. I'm Joey Wahler. Hi there, Doctor. Welcome.

Michael Davidson, MD: Hello. Thank you for having me.

Host: Great to have you aboard. We appreciate the time. So first, let's say I feel perfectly healthy. Why should I still make an annual physical a priority?

Michael Davidson, MD: Yeah, I would say the biggest thing that we look for in these annuals is prevention. So, preventative healthcare screenings to either identify something before it develops or potentially treat something in the very early stages.

Host: And oftentimes when you're healthy, that could be the best time to get a physical because it keeps things just that way, right?

Michael Davidson, MD: Absolutely. So, I always kind of give the analogy of taking your car to get an oil change. There's not necessarily anything wrong with the engine. The car is running fine, but we do these routine maintenances to help the car kind of run better in the near future. So, some of these preventative health screenings are kind of like that.

Host: Great analogy that I'm sure everyone can relate to. I know I can. So, what are some of the health problems in your experience that you can catch during a routine physical before a patient ever notices symptoms on their own?

Michael Davidson, MD: Yeah. So, I think one of the big things that we do is some basic blood work, looking at a patient's cholesterol level. Cholesterol levels on their own and in combination with family history can give us a lot of information, right? So, we can predict things like what is the risk of a heart attack or a stroke in the future, and potentially prevent that from coming about. We also look at things like cancer screenings, colonoscopies are able to remove polyps that could be pre-cancerous in terms of colon cancer. And this just keeps people healthy in the long run.

Host: And you mentioned high cholesterol. That, of course, very often leads to heart disease if it gets out of control, right?

Michael Davidson, MD: It absolutely does. You know, so we look at these numbers, we look at their lifestyle, we look at the family history, kind of take a full picture of the patient and kind of tailor our prevention towards that patient.

Host: So, I know that there are many people who've never had a physical. Doesn't necessarily mean they don't go to the doctor at all. It could mean they go to the doctor regularly, but they've just not had a full-blown physical. So for those unfamiliar, what does it include and what are you looking for?

Michael Davidson, MD: Yeah. So, I can kind of take you through the basic workup of what I do in my office and what most primary care doctors would do. Generally, it's going to start with meeting with one of the nurses or a medical assistant, getting some vitals done. And then, once I come in, we'll start with some basic questions. I'll ask you about lifestyle, family history, are they on any medications now, any symptoms they might be having. We'll do a head-to-toe physical exam, and then really we're looking at some basic things. So, basic blood work, looking for your blood sugar level, cholesterol level, your kidney health, and then some screenings that may be tailored specifically towards your lifestyle and your ages. That's when we kind of get into the colonoscopies, mammograms, and some other things.

Host: And how do factors like age, family history, which you touched on, lifestyle, and personal risk factors overall, how does that change what you recommend checking or screening for?

Michael Davidson, MD: Yeah. So, there are recommendations for these screening guidelines. So, kind of generalized recommendations based on a person's age, right? So, a colonoscopy generally starting at the age of 45. If someone has a family history of colon cancer, we may recommend starting those screenings earlier.

Another big one is the breast cancer screening. So, like, early screening of breast cancer, a lot of patients may have heard of like the BRCA mutation. So, bringing a family history of that may give your doctor more information to potentially order something like that. And then, of course, there's lifestyle modifications like smoking that may warrant additional screenings.

Host: Speaking of screenings, when it comes to them as well as vaccines, some of the routine tests you mentioned, what are the ones where people are commonly falling behind most because perhaps they're skipping their annual visits?

Michael Davidson, MD: Yeah. So, I'll kind of start with the vaccinations. So, annual flu shots, coming out every year, really important, right? We're getting into cold and flu season now, and people who have some comorbidities like asthma and COPD or just being a little bit older, they are at an increased risk of serious infections with those types of illnesses. So, missing on an annual, missing on an annual flu shot could potentially be dangerous for patients.

Guide test-wise, you know, we're looking at things that may require a patient to potentially take some time off of work, schedule it. So, things like colonoscopies, which are really important to get, those things can be missed, right? If you're not meeting with your primary care doctor and not getting an order for it, and having someone kind of walk you through, you know, what is the procedure like.

Host: So in terms of a couple of those screenings that you mentioned, whether it's a mammogram for women, prostate for men, colonoscopy for either, can you talk to us please about the importance of that? Because so often cancers in those areas can be, at the very least, not as bad when they're caught or quite possibly prevented if only people stay on top of it, right?

Michael Davidson, MD: Absolutely. So when we're looking specifically at colon cancer, breast cancer, prostate cancer, those cancer screenings, we're catching the cancer very early on, right? So in colon cancer, doing a colonoscopy or doing one of the stool tests that are FDA-approved for screening for colon cancer, you can detect the cancer early.

In terms of the colonoscopy, we're removing that precancerous polyp. In terms of a mammogram, we're identifying things that someone may not feel. So in stuff like colon cancer, you may not have symptoms of colon cancer. You might not feel bad until the cancer grows to a level where it's actually blocking something off. Same thing with breast cancer. You may not feel the lump. You might not have changes related to breast cancer. So, we're catching it very early, removing it, and giving the patient success in the future.

Host: Beyond catching diseases like that early, which you just mentioned, how does having a regular relationship with a primary care doctor like yourself benefit a patient over the long haul? Because there are real benefits, right?

Michael Davidson, MD: Absolutely. So, prevention aside, what are some other things that we kind of do as primary care physicians? So, family medicine, internal medicine, even pediatrics for, you know, some younger people out there. What I would say is we are kind of the point of contact for a lot of these other specialties, right?

So as I'm referring you out to people, as I'm getting labs, I'm kind of coordinating a lot of this care, right? So I know it can be stressful to, you know, go have a colonoscopy, having a great talk with the GI doctors, but then we're kind of lost and, "Okay, well, what's the next step? You know, what do we do now? What do we do about my cholesterol? What do we do about all this kind of stuff?" So, having that relationship is really good.

The other thing that I kind of always bring up to patients is, are there chronic problems that we're having, that people might be putting off? Knee pain, back pain. A lot of those things can be dealt with in the outpatient setting with someone you trust, is going to help people stay out of the emergency department, keep their costs low, and avoid kind of running around the healthcare system

Host: And that steady relationship between patient and doctor benefits you, the physician, as well, doesn't it? Because the familiarity that that helps to form really works both ways, yes?

Michael Davidson, MD: Absolutely. You know, one of the great things about family medicine and primary care is I get to grow with my patients. You know, I see people from newborn all the way up to geriatric age. So, going through that development with them, knowing their family, knowing kind of, you know, what works for them, that relationship, not having to start from ground zero is really important.

Host: And it also helps kind of color things in a little bit too in terms of when you get to know someone, I would imagine it lets you know, is this someone that tends to procrastinate? Is this someone on the other hand that may be an alarmist and overreacts? And tthat helps you too, right?

Michael Davidson, MD: It absolutely does. You know, I always say, we're not treating the numbers, we're treating the patient. So, something that works for one patient may not work for another person. They might have adverse effects of it. It could be a cost thing. there could be some hesitation in it, and we can kind of tailor our treatment towards that patient specifically

Host: And then in summary, having said all of the above for someone joining us right now who's not had a physical in several years, what would you tell them about getting back on track, taking that first step, and then what they should basically expect at that initial appointment?

Michael Davidson, MD: Do not be nervous about a physical exam. I know a lot of people go in with the assumption that we're going to find a bunch of diseases. We're going to yell at them about their diet and exercise habit. That's not really what we're doing. We're forming a relationship, you know.

And it's completely fine to tell your doctor, "I'm okay with talking about this screening, but I really would prefer another appointment because it's a lot of information for me." So, take it slow. it's a team effort. we're here to help you in the long run, and just kind of make a great doctor-patient relationship.

Host: Words that I would think make anyone joining us right now very comfortable about the situation. Well, folks, we trust you are now indeed more familiar with annual physicals. Doctor, keep up all your great work, and thanks so much again.

Michael Davidson, MD: Thank you.

Host: And for more information, please visit silvercross.org/medical-group. If you found this podcast helpful, please do share it on your social media. And thanks so much again for being part of Silver Cross Hospital's iMATTER Health Podcast.