Getting Started: Data and Health History

At the beginning of your visit, I will collect important baseline information, including:
 

• Height, weight, and body mass index (BMI)

• Blood pressure, heart rate, respiratory rate, temperature, and oxygen saturation

• Vision screening

I will then review your:
 

• Past medical history

• Immunizations

• Current medications and supplements

• Allergies

• Lifestyle factors, including nutrition, exercise, sleep, tobacco, alcohol, and other health behaviors

• Family history

• Personal health goals and any questions or concerns you would like to discuss

I will also review your personal concerns to identify any conditions involving any of the body systems.

Head-to-Toe Physical Examination
 

After discussing your health history, I will perform a physical examination.

This includes assessment of:
 

• General appearance and vital signs

• Skin, hair, and nails

• Head, eyes, ears, nose, and throat (HEENT)

• Neck and lymph nodes

• Heart and circulation

• Lungs and breathing

• Abdomen and digestive system

• Neurological function

• Musculoskeletal system

• Peripheral circulation and extremities

     
     Specialized Screenings When Indicated

          Cognitive Exams
 

For patients with cognitive difficulties, standardized cognitive screening exams may be performed. 
 

          Diabetes Foot Examination

For patients with diabetes, I may perform a foot examination, including:
 

• Evaluation of skin integrity

• Assessment of foot structure

• Evaluation of circulation

• Sensation testing for neuropathy

          Pediatric and Adolescent Health

For children and adolescents, age-appropriate preventive evaluations may include:
 

• Growth and development assessment

• Puberty staging when appropriate

• Screening for age-specific health concerns

Evidence-Based Preventive and Health Screenings
 

Preventive care recommendations are guided by current evidence and recommendations from several medical organizations. The most notorious organization that most insurers follow is the United States Preventive Services Task Force (USPSTF).  Additional recommendations may also stem from FDA-approved tests and screening tools, along with recommendations from professional organizations including the Centers for Disease Control and Prevention (CDC), the American Academy of Family Physicians (AAFP), the American Cancer Society (ACS), and the American College of Obstetricians and Gynecologists (ACOG).

Because preventive recommendations continue to evolve as new evidence becomes available, screening decisions are personalized based on the risks versus benefits as well as your age, medical history, family history, medications, lifestyle factors, personal risk factors, and individual health goals.

     Sexual Health Screening

For patients who are sexually active, screening recommendations may include testing for sexually transmitted infections (STIs), especially as many do not present with any symptoms. For example, one recommended routine screening is for chlamydia and gonorrhea in sexually active females younger than 25 years of age, as well as screening in older individuals based on individual risk factors. This can be performed with a urine sample or vaginal swab. There are also a few other recommended screenings based on certain high-risk sexual practices. 

     Laboratory Screening

Depending on your age, health history, and risk factors, laboratory testing using blood may be recommended to evaluate for conditions such as:
 

• Diabetes or prediabetes

• Thyroid disorders

• Lipid disorders

• Kidney and liver function

• Blood cell counts and electrolytes

     Cancer Screening and Risk Assessment

Preventive visits also provide an opportunity to discuss recommended cancer screenings based on current guidelines and personal risk factors, including:
 

• Prostate cancer screening (including prostate-specific antigen (PSA) testing when appropriate)

• Breast cancer screening

• Cervical cancer screening (including HPV and/or Pap test when appropriate)

• Colorectal cancer screening (including blood-based, stool-based, or colonoscopy when appropriate) 

• Skin cancer awareness and evaluation of concerning lesions

     Other Screenings
 

• Low-dose CT for Lung Cancer Screening for some smokers

• Osteoporosis Screening- Bone density scan

• Abdominal Aortic Aneurysm Screening for certain men

     Pediatric and Adolescent Preventive Care
 

For children and adolescents, preventive visits focus on healthy growth, development, and early identification of health concerns. Depending on the specific age, this may include:
 

• Growth and developmental assessments

• Vision and hearing screening

• Immunization review

• Mental health screening

• Autism screening

• Lab blood draws for conditions such as anemia, lead, or lipid disorders

Preventative physicals are designed to focus on prevention, health maintenance, screening recommendations, and identifying health risks before they become larger problems. The purpose of preventive screening is not to order every test for every person. Instead, the goal is to use evidence-based recommendations to identify health risks early and provide personalized care based on each patient's unique needs.
 

If you have a new medical concern, worsening symptom, or a specific health issue you would like addressed during your visit, please discuss it with me. Your concerns are important, and we will determine the best way to evaluate and manage them. Depending on the complexity of a new problem addressed during a preventive visit, additional services may be billed separately according to guidelines and payment policies. This is never intended to discourage you from bringing up concerns.