Taking care of your health on a daily basis includes regular check-ups with your doctor. Getting your annual physicals can be one of the most important things you do for yourself and your loved ones. However, it can seem confusing as to which screenings you should get or and how often you should get them.
Listen as Sonia Dar, MD explains that taking part in preventive exams can go a long way toward staying healthy as you age.
Selected Podcast
The Importance of Annual Preventive Exams
Featured Speaker:
Sonia Dar, MD
Dr. Sonia Dar practices family medicine at Rochester Regional Health. Transcription:
The Importance of Annual Preventive Exams
Bill Klaproth (Host): The annual exam or physical has become commonplace for people who are hoping to head off problems before it's too late and here to tell us more is Dr. Sonya Dar of Rochester Regional Health. Dr. Dar, thank you for your time.
Dr. Sonya Dar (Guest): Hi Bill, thanks for having me here.
Bill: Oh, no problem. I'm looking forward to talking to you about this. What age should patients start thinking about annual exams?
Dr. Dar: Well, you know, to start off, I really think that primary care providers are the gatekeepers of medicine. So, developing a strong and close relationship with your PCP, or primary care provider, helps us and the patients stay on top of all of their health care needs. This improves your long-term outcomes, it decreases their chances of hospitalization, and it decreases the burden on the overall healthcare system. So, starting at a young age. Obviously, we love to see babies. Pediatric screening is very important, especially to remain up to date with all of your vaccinations and to make sure that children are reaching their developmental milestones. So, usually about every two to three months until they're 24 months, and then we can space it out to every year until they're six, and then if they're generally healthy, every other year. In terms of adults, really there's no current evidence to support yearly physicals, but, again, like I said, maintaining a relationship with your primary care provider is important for insuring that we get to educate and counsel patients on preventative health. So, coming in yearly, bi-annually, is appropriate, as well.
Bill: It's probably one of the more important relationships in your life and it makes sense to cultivate that because your health is so important. So, if you're a healthy person, should you start the annual or bi-annual exams at what age? Like 50? When should you start thinking about "Okay, I'm good. I haven't' seen the doctor in a number of years, but maybe it's time to start"?
Dr. Dar: Right. I think coming in at the age of 18 is appropriate, and then, after that, if you have no medical conditions and if you're in absolute good health, then coming in once you’re in your 30s to 40s is probably appropriate.
Bill: So, kind of maybe once you hit your 30 or your 30th birthday, go; 40th, go; 50th, go, and then when does it switch into bi-annual and annual?
Dr. Dar: I think around the age of 50 and if you start developing more chronic health conditions, then at the age of 50, you probably should be coming in to see us every year and definitely there are times that patients do need to come in, and those are for particular screening tests, which we'll talk about.
Bill: Can you talk about the different types of screening exams based on age and gender?
Dr. Dar: Yes, absolutely. So, let's start off with females. So, if you're a female, the first screening exam that you usually think about is a pap smear and recently, there've been changes to the recommendations of how often and when to perform pap smears. So, pap smears are screenings for cervical cancer which has been linked to the human papillomavirus, which there are now immunizations for and, again, patients should be seen in their teenage years to discuss that immunization. But currently, the US Preventative Services Task Force, or the USPSTF, recommends screening women starting at the age of 21, and this no longer depends on your sexual history at all. Everyone starts at age 21. Between 21-30 years of age, you should be screened every three years, no longer yearly; however, if you have abnormal results, this can change. After the age of 30 until you're 65, you can be tested concurrently for your cytology and your HPV, and if those are negative, you can actually space screening to every five years. The next thing women think about is their mammograms, and there's actually a lot of discussion around when to begin screening for breast cancer and how often you should perform the test. Depending on which organization or governing body you talk to, the recommendations are different. So, I personally usually start discussing breast cancer screening with women when they enter their 40s and really let them have some autonomy over when they would like to be screened, taking into account, obviously, their personal and their family history of breast cancer. I strongly recommend mammogram screenings starting at age 50 and then every year or every two years, depending on patient preference. And that's usually at the age of 74.
Bill: Well, those are terrific guidelines. What about male screening exams?
Dr. Dar: So, particular to males is screening for abdominal aortic aneurysm and that's between 65-75 years in any man with any history of smoking and it's only a one-time abdominal ultrasound. The other thing that is very common and most men worry about is prostate cancer screening. So, again, with this one, there's a lot of talk about it and the US Preventative Services Task Force and the American Urological Association actually recommend against routine screening of prostate-specific antigen or the PSA antigen. However, between ages 55-69, again, this can be based on shared decision-making, and that's why it's important to have that relationship with your primary care provider so that you can talk about that type of screening. And then, there are the screening exams that are shared for male and female. The important ones are hypertension screening. Usually that begins at age 18 and also depends on your family history. Diabetes, we start screening at the age of 40, and also depending on your personal conditions, like if you're overweight or obese. Cholesterol screening is part of routine screening in adults. And then the big one is the colonoscopy to screen for colon cancer. That starts at age 50, depending on your family history and usually it can be done every 10 years, depending on the results of it until you're 75.
Bill: I just had mine done about six months ago.
Dr. Dar: You did? Awesome, and how was it? It's one of those tests that a lot of people dread.
Bill: It was so easy. My sister, who is older than me, she is in her 60s, I'm like, “Why haven't you gone and gotten it?” and she says "I don't want to. I'm afraid," I said "You have to go do this." So, she wouldn't do it, she just went and did it and she was like, "It was so easy. I don't know why I was so worried about it." So.
Dr. Dar: Right. Right. They do use conscious sedation, so you hopefully won't even know what's happening to you and it'll be over before you know it. But there are other options if people don't want to do the colonoscopy screening. There are fecal blood tests and you can always talk to your doctor about that.
Bill: And are there other screening exams that you could just quickly touch on that we should be aware of?
Dr. Dar: Definitely and you know what? These are things that I think a lot of patients don't realize, but primary care providers screen for depression, they screen for alcohol and substance abuse, they screen for cognitive impairment, especially in the elderly, they screen for sexually transmitted infections, and those are just a few of many things that we do screen for.
Bill: Okay. Insurance is certainly a hot topic in the world we live in today. What does insurance cover annually?
Dr. Dar: Yes. So, honestly, every insurance company is different, but every company should cover at least one annual exam, and the best way to go about it is to call your insurance company, find out when you're due for your test because there are instances where patients will come a little bit too early for that one-year mark, and then they will be charged for it. So, if you have any questions, call your insurance company. But, they should cover one annual exam every year.
Bill: Alright, and Dr. Dar, I imagine the annual exam is a great way to keep health information updated regularly, which is really important for your physician to know. So, are there other certain things that we should be updating, you know, as time goes on?
Dr. Dar: Well, Bill, if there's one that I have to stress, it's your medication list. If you can keep an up-to-date list of all your medications in your wallet and next to each medication, write down the reason that you're taking it, I cannot tell you how beneficial this would be to the patient and to their primary care provider. Because oftentimes, we do get patients who are on a number of medications and they don't know why, they're not sure if they're taking them appropriately, and this really helps us out if you can have an up-to-date list with you at every visit. Keeping track of your immunizations if you can, but nowadays with our electronic medical records, we do a pretty good job of keeping those up-to-date. Keeping a business card even of all of your doctors’ names, that can sometimes help us out, too, so we know exactly who you're seeing and where we need to obtain records from. Depending on certain conditions that you have, if you have diabetes, then keeping a log of your blood sugar readings at home, and if you have a history of high blood pressure and if you monitor your blood pressure at home, again, keeping a blood pressure log, that really helps us out.
Bill: I think that is really good advice and I think those are things that people just don't do. If you need them again, since this is a podcast, just hit rewind and listen to those again, because I think those are really important. And, Dr. Dar, if you could wrap it up for us, why should someone choose Rochester Regional for their health care needs?
Dr. Dar: Well, Bill, I really think that Rochester Regional is just a community of really well-trained, compassionate, great physicians. It’s all-inclusive, all of your health care records are in one place, and I can't say enough good things about it.
Bill: Dr. Dar, thank you so much for your time, today. You're listening to Rock Your Health Radio with Rochester Regional Health. For more information, you can go to www.rochesterregional.org. That's www.rochesterregional.org. I'm Bill Klaproth. Thanks for listening.
The Importance of Annual Preventive Exams
Bill Klaproth (Host): The annual exam or physical has become commonplace for people who are hoping to head off problems before it's too late and here to tell us more is Dr. Sonya Dar of Rochester Regional Health. Dr. Dar, thank you for your time.
Dr. Sonya Dar (Guest): Hi Bill, thanks for having me here.
Bill: Oh, no problem. I'm looking forward to talking to you about this. What age should patients start thinking about annual exams?
Dr. Dar: Well, you know, to start off, I really think that primary care providers are the gatekeepers of medicine. So, developing a strong and close relationship with your PCP, or primary care provider, helps us and the patients stay on top of all of their health care needs. This improves your long-term outcomes, it decreases their chances of hospitalization, and it decreases the burden on the overall healthcare system. So, starting at a young age. Obviously, we love to see babies. Pediatric screening is very important, especially to remain up to date with all of your vaccinations and to make sure that children are reaching their developmental milestones. So, usually about every two to three months until they're 24 months, and then we can space it out to every year until they're six, and then if they're generally healthy, every other year. In terms of adults, really there's no current evidence to support yearly physicals, but, again, like I said, maintaining a relationship with your primary care provider is important for insuring that we get to educate and counsel patients on preventative health. So, coming in yearly, bi-annually, is appropriate, as well.
Bill: It's probably one of the more important relationships in your life and it makes sense to cultivate that because your health is so important. So, if you're a healthy person, should you start the annual or bi-annual exams at what age? Like 50? When should you start thinking about "Okay, I'm good. I haven't' seen the doctor in a number of years, but maybe it's time to start"?
Dr. Dar: Right. I think coming in at the age of 18 is appropriate, and then, after that, if you have no medical conditions and if you're in absolute good health, then coming in once you’re in your 30s to 40s is probably appropriate.
Bill: So, kind of maybe once you hit your 30 or your 30th birthday, go; 40th, go; 50th, go, and then when does it switch into bi-annual and annual?
Dr. Dar: I think around the age of 50 and if you start developing more chronic health conditions, then at the age of 50, you probably should be coming in to see us every year and definitely there are times that patients do need to come in, and those are for particular screening tests, which we'll talk about.
Bill: Can you talk about the different types of screening exams based on age and gender?
Dr. Dar: Yes, absolutely. So, let's start off with females. So, if you're a female, the first screening exam that you usually think about is a pap smear and recently, there've been changes to the recommendations of how often and when to perform pap smears. So, pap smears are screenings for cervical cancer which has been linked to the human papillomavirus, which there are now immunizations for and, again, patients should be seen in their teenage years to discuss that immunization. But currently, the US Preventative Services Task Force, or the USPSTF, recommends screening women starting at the age of 21, and this no longer depends on your sexual history at all. Everyone starts at age 21. Between 21-30 years of age, you should be screened every three years, no longer yearly; however, if you have abnormal results, this can change. After the age of 30 until you're 65, you can be tested concurrently for your cytology and your HPV, and if those are negative, you can actually space screening to every five years. The next thing women think about is their mammograms, and there's actually a lot of discussion around when to begin screening for breast cancer and how often you should perform the test. Depending on which organization or governing body you talk to, the recommendations are different. So, I personally usually start discussing breast cancer screening with women when they enter their 40s and really let them have some autonomy over when they would like to be screened, taking into account, obviously, their personal and their family history of breast cancer. I strongly recommend mammogram screenings starting at age 50 and then every year or every two years, depending on patient preference. And that's usually at the age of 74.
Bill: Well, those are terrific guidelines. What about male screening exams?
Dr. Dar: So, particular to males is screening for abdominal aortic aneurysm and that's between 65-75 years in any man with any history of smoking and it's only a one-time abdominal ultrasound. The other thing that is very common and most men worry about is prostate cancer screening. So, again, with this one, there's a lot of talk about it and the US Preventative Services Task Force and the American Urological Association actually recommend against routine screening of prostate-specific antigen or the PSA antigen. However, between ages 55-69, again, this can be based on shared decision-making, and that's why it's important to have that relationship with your primary care provider so that you can talk about that type of screening. And then, there are the screening exams that are shared for male and female. The important ones are hypertension screening. Usually that begins at age 18 and also depends on your family history. Diabetes, we start screening at the age of 40, and also depending on your personal conditions, like if you're overweight or obese. Cholesterol screening is part of routine screening in adults. And then the big one is the colonoscopy to screen for colon cancer. That starts at age 50, depending on your family history and usually it can be done every 10 years, depending on the results of it until you're 75.
Bill: I just had mine done about six months ago.
Dr. Dar: You did? Awesome, and how was it? It's one of those tests that a lot of people dread.
Bill: It was so easy. My sister, who is older than me, she is in her 60s, I'm like, “Why haven't you gone and gotten it?” and she says "I don't want to. I'm afraid," I said "You have to go do this." So, she wouldn't do it, she just went and did it and she was like, "It was so easy. I don't know why I was so worried about it." So.
Dr. Dar: Right. Right. They do use conscious sedation, so you hopefully won't even know what's happening to you and it'll be over before you know it. But there are other options if people don't want to do the colonoscopy screening. There are fecal blood tests and you can always talk to your doctor about that.
Bill: And are there other screening exams that you could just quickly touch on that we should be aware of?
Dr. Dar: Definitely and you know what? These are things that I think a lot of patients don't realize, but primary care providers screen for depression, they screen for alcohol and substance abuse, they screen for cognitive impairment, especially in the elderly, they screen for sexually transmitted infections, and those are just a few of many things that we do screen for.
Bill: Okay. Insurance is certainly a hot topic in the world we live in today. What does insurance cover annually?
Dr. Dar: Yes. So, honestly, every insurance company is different, but every company should cover at least one annual exam, and the best way to go about it is to call your insurance company, find out when you're due for your test because there are instances where patients will come a little bit too early for that one-year mark, and then they will be charged for it. So, if you have any questions, call your insurance company. But, they should cover one annual exam every year.
Bill: Alright, and Dr. Dar, I imagine the annual exam is a great way to keep health information updated regularly, which is really important for your physician to know. So, are there other certain things that we should be updating, you know, as time goes on?
Dr. Dar: Well, Bill, if there's one that I have to stress, it's your medication list. If you can keep an up-to-date list of all your medications in your wallet and next to each medication, write down the reason that you're taking it, I cannot tell you how beneficial this would be to the patient and to their primary care provider. Because oftentimes, we do get patients who are on a number of medications and they don't know why, they're not sure if they're taking them appropriately, and this really helps us out if you can have an up-to-date list with you at every visit. Keeping track of your immunizations if you can, but nowadays with our electronic medical records, we do a pretty good job of keeping those up-to-date. Keeping a business card even of all of your doctors’ names, that can sometimes help us out, too, so we know exactly who you're seeing and where we need to obtain records from. Depending on certain conditions that you have, if you have diabetes, then keeping a log of your blood sugar readings at home, and if you have a history of high blood pressure and if you monitor your blood pressure at home, again, keeping a blood pressure log, that really helps us out.
Bill: I think that is really good advice and I think those are things that people just don't do. If you need them again, since this is a podcast, just hit rewind and listen to those again, because I think those are really important. And, Dr. Dar, if you could wrap it up for us, why should someone choose Rochester Regional for their health care needs?
Dr. Dar: Well, Bill, I really think that Rochester Regional is just a community of really well-trained, compassionate, great physicians. It’s all-inclusive, all of your health care records are in one place, and I can't say enough good things about it.
Bill: Dr. Dar, thank you so much for your time, today. You're listening to Rock Your Health Radio with Rochester Regional Health. For more information, you can go to www.rochesterregional.org. That's www.rochesterregional.org. I'm Bill Klaproth. Thanks for listening.