Going for your annual checkup? Dr. Wen explains what health issues to pay attention to
By Katia Hetter, CNN
Many people have been putting off routine medical care during the Covid-19 pandemic. Now that many US adults are vaccinated and the rate of new infections is much lower, it’s time to make sure you are up-to-date on all of your key medical screenings and health maintenance.
If you are headed to your doctor for your annual checkup, what should you expect? What are key questions to ask? And what are some issues your doctor may not bring up, but you might want to consider?
We turned to CNN Medical Analyst Dr. Leana Wen to ask for her advice. Wen is an emergency physician and visiting professor of health policy and management at the George Washington University Milken Institute School of Public Health. She is the author of the patient advocacy book “When Doctors Don’t Listen: How to Avoid Misdiagnoses and Unnecessary Tests” and of the forthcoming “Lifelines: A Doctor’s Journey in the Fight for Public Health.”
CNN: To begin with, how often should people be seeing their doctor if there is nothing wrong — if they want a checkup?
Dr. Leana Wen: In general, adults should see their primary care physician once a year for an annual exam. Children may need more frequent visits, especially when they’re younger, to check growth and receive their immunizations. If you have chronic medical conditions, for example diabetes or heart disease, you will probably need to see your doctor more often.
CNN: Why is the annual checkup so important?
Wen: It’s important for three key reasons. First, prevention is key — you want to detect small problems before they become big ones. For example, we want to find high blood pressure and begin to treat it before it goes on for so long that it could cause permanent damage to your vessels and to your heart. Cancer screenings are done for this reason, too, to diagnose as early as possible.
Second, this is the opportunity to talk to your doctor about concerns you might have that aren’t necessarily urgent, but are important to you. You may have had trouble sleeping or have ongoing back pain or seasonal allergies. Maybe these issues didn’t rise to the level that you’d call your doctor for an appointment just to address that one problem, but these routine visits are where you should get all these smaller concerns addressed.
Third, clinical care is best when there is an established doctor-patient relationship. The annual visit is a great time to build trust and to have your health care provider get to know you, your health and your values.
CNN: What can you expect during the annual exam?
Wen: There will be some variation depending on your doctor. I’d first call and make sure you know any regulations that are in place. Some doctors’ offices are not allowing visitors, for instance, because of Covid-19 rules. Others might request that part of the visit be telemedicine and the other part in person. The in-person part may require a symptom questionnaire to be filled out in advance.
If this is a doctor you have seen before, there will probably be minimal new paperwork. If it’s a new practice, you should inquire about what forms you could complete in advance, such as your insurance information and medical history questionnaire.
Once you arrive, you’ll have your vital signs checked: your temperature, blood pressure, heart rate, respiratory rate and oxygen saturation. The doctor will ask you how you’ve been doing and what concerns you might have. They will go through your list of existing medications, ask you if you have experienced a series of physical symptoms, and inquire about issues related to your overall health, such as your mood; drug, tobacco or alcohol intake; and your living situation.
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You’ll also go over any health screenings that need to be done. Depending on your age and when you last had them, you may need to have blood tests screening for anemia, kidney or liver problems, high cholesterol, and diabetes. You may need cancer screenings — a pap test, mammogram, colonoscopy and so forth. Your doctor will also talk to you about immunizations, including whether you have received your Covid-19 vaccine.
CNN: Is mental health part of the visit?
Wen: Addressing mental health certainly should be. Unfortunately, mental health is something that hasn’t always been regarded as seriously as physical health. Not every provider necessarily asks about it.
If you are asked about how your mood has been and how you’ve been, share with your doctor what’s going on. Know that it’s normal and very common to have concerns about your mental well-being. Depression, anxiety and other mental health issues were underdiagnosed prior to the pandemic, and the stress of Covid-19 could have exacerbated underlying issues.
Even if you’re not asked about it, please mention your mental health to your doctor. Talk about changes in how you’re doing. For example, make sure to bring up if you are under a lot of stress or have been feeling down or more anxious than usual. Your doctor should ask you about drinking alcohol; being honest about how much you’re drinking can help your doctor to diagnose potential excessive drinking and assist you with it.
Most physicians aren’t mental health specialists, but they can refer you to one. It often helps to talk to a therapist, counselor, psychologist or other specialist. Know that your doctor will want to help you tend to your mental health, but they can only assist if you bring up what’s troubling you.
CNN: What happens if you have put off your checkup for a while because of Covid-19?
Wen: You’re not alone — many people have been putting of their regular exams because of the pandemic. Now is the time to make sure you get caught up. Let your doctor know when the last time was that you had a checkup.
CNN: What should you bring to your doctor’s visit?
Wen: First, make sure to bring anything that the doctor’s office requests of you, such as insurance information. Ask in advance if you should be fasting for the purposes of any blood tests that need to be done during the visit.
Be sure to also bring a list of your medications. It helps to have the actual pill bottles so that all the doses and amounts left can be easily read. I’d also make a list of questions and concerns in advance. Write them down and bring the list with you. In the moment, it’s often hard to remember, and you should make sure that your questions are answered before you leave your visit.
CNN: What are some things you should be sure to bring up to your doctor even if they don’t ask you about it?
Wen: Certainly, you should bring up anything that’s on your mind. Don’t be shy about asking about anything. I always tell my patients that they are the expert when it comes to their body, and doctors aren’t mind readers — we need you to tell us what’s concerning you. There is no such thing as a silly question. That mole might just require a referral to a dermatologist, or that headache could be a sign of dental problems that require further diagnosis and care.
There are some sensitive topics that some patients may feel hesitant to bring up.
Your doctor should ask about your mental health, as we discussed above. In addition, ideally your doctor should bring up sexual health, and ask about sleep, and about nutrition and exercise. These are also key to our overall health and well-being. Be prepared to talk about them, and to bring up these topics if your doctor doesn’t.
Finally, know when to follow up. Covid-19 has highlighted how critical our health is, and it’s important for all of us to take care of our routine medical issues to improve our mental and physical well-being.
