Have you seen your primary care doctor recently? If the answer is no, you’re not alone.
During the COVID-19 pandemic, in-person primary care visits dropped by 60% during the pandemic’s peak in 2020. The number of primary care visits in America was already declining by 2% between 2012 and 2016.
While that number has rebounded a bit since early 2022, according to the Commonwealth Fund, it’s still low. One-third fewer people have seen a primary care doctor in person this year compared to pre-COVID times.
It’s worth noting that while the number of in-person visits dropped during the pandemic, many people are still seeing their doctors via telehealth or online visits. No matter how you book a primary care appointment, it’s important to get one on the calendar if you — like so many of us — have skipped your basic preventive care and screenings during the past two years.
Why health screenings matter
According to Dr. Nina Maisterra, a family medicine physician and clinic chief at UW Medicine Primary Care at South Lake Union, seeing your primary care doctor regularly is vital to maintaining your health and preventing possible future health problems. And the frequency you need to go may vary based on your age and individual risk factors.
Maisterra says screenings can provide opportunities for healthy lifestyle changes, especially when it comes to preventing illnesses that grow out of unhealthy behaviors. In other words, a screening can help you identify potential health problems before they become bigger and more challenging.
“Early prevention and early detection can improve health and survival,” she says. “Ask to discuss with your doctor what screenings are appropriate for you based on age, risk factors, family history and personal preference.”
These regular health screenings, which can be conducted at any annual wellness visit, help your primary care doctor get a sense of your overall health risks and current status of any mental, physical and emotional health issues. The visits are usually reimbursed by health insurance and may require a referral to a specialist if there is a concern or need for more information.
Here are six important screenings to ask about at your next routine primary care exam:
Flu shots, COVID boosters and other vaccines
Did you get your flu shot this year? If not, you should — even if you’re healthy.
It might not be a health screening, but it still counts as preventive care. According to the Centers for Disease Control and Prevention (CDC), nearly 80,000 Americans died of flu and flu-related diseases during the 2017-2018 flu season, more than any of the previous 40 years. Hospitalizations and illnesses last year also hit a record high during this period, but only 37% of adults got their flu shot.
In addition to your flu shot, it’s also important to remember to get your COVID-19 booster. Everyone five or older who is already fully vaccinated against COVID-19 is eligible to get a booster.
As of 2022, the CDC recommends that everyone gets a flu vaccine while getting their COVID-19 vaccine or booster, as many of us will be more susceptible to getting both viruses after a few years spent in isolation. And while you’re at it, see if you’re up to date on other vaccines you might need, like tetanus/diphtheria, pertussis (aka whooping cough), shingles and more recently, monkeypox. If you have an international trip coming up, be sure to mention that, too.
Maisterra says most people will need to undergo at least a few cancer screenings regularly, especially as they get older. A few of the most essential screenings are breast cancer screening, colon cancer screening, cervical cancer screenings and skin cancer screenings.
Most women and people assigned female at birth who are at average risk should get a cervical cancer screening test starting at age 25 and then every five years after that,” Maisterra says. “Pap smears and human papillomavirus testing screen for cervical cancer, which is treatable if caught early enough.”
Newer tests look for human papillomavirus (HPV), which can lead to cervical cancer. If your pap smear or HPV testing is abnormal, your doctor may suggest more frequent screenings or another procedure like a colposcopy. That said, check with your doctor, as these recommendations can vary based on your health issues.
If you’re at average risk, a colorectal cancer screening test is recommended for adults starting at age 45. This can be done through a colonoscopy, a fecal immunochemical test (FIT), a stool DNA test or other methods that your doctor might suggest.
While these tests screen for colon cancer, they can also help doctors evaluate the root of other potential problems, like blood in the stool, unexplained weight loss, anemia and abdominal pain.
Typically, you’d only get one of these screenings every 10 years, but if you have risk factors such as a family history of colon cancer, ulcerative colitis or other conditions associated with a higher rate of colon cancer, your doctor might suggest scheduling them more frequently. You may need to have a colonoscopy done earlier than 10 years if advised by your doctor if there were polyps or other findings on a previous colonoscopy. You will need to discuss with your doctor on these individual recommendations.
Again, it’s important to check with your doctor to see what recommendations are right for you.
A mammogram is also recommended for women and people assigned female at birth starting at age 50, according to the U.S. Preventive Services Task Force. However, some people might need or prefer to get screened in their 40s or earlier based on their personal risk or preferences after a discussion with your doctor.
If you have a family history of breast cancer or may be at higher risk, this might be a reason to talk to your doctor about getting a mammogram sooner rather than later.
For example, Black women on average are diagnosed with breast cancer at an earlier age, but the mortality rate is 39% higher among this demographic. Because Black women on average are diagnosed earlier, this might be a reason for an earlier mammogram.
Additionally, transgender women who are over the age of 50 and have undergone hormone replacement therapy (HRT) for five to 10 years should talk to their doctor to see if and when a mammogram is right for them.
Another preventive screening to consider scheduling is a visit to your dermatologist or your primary care doctor for a skin check. This is usually for patients at higher risk for skin cancer based on family history, sun exposure or other medical conditions.
At this appointment, your doctor may ask if you’ve noticed any unusual spots, moles or changes in your skin and do an exam to see if there are any concerning moles or skin lesions. If so, this can help determine if you need further testing for skin cancer.
Heart health is key to your overall wellness, so most doctors recommend undergoing a set of tests during your wellness visits. If you schedule a physical exam with your primary care doctor, you should expect a blood pressure screening to check for high blood pressure, a risk factor for heart disease.
At your visit, your doctor will offer to have your height and weight measured. In some cases, this can help determine if you’re at risk for other conditions. (It’s worth noting that you can forgo the weight check if you wish.) If your doctor doesn’t automatically provide these checks, don’t be afraid to ask for them.
Maisterra also says to consider cholesterol screenings, which are typically recommended in adulthood. This is especially important if high cholesterol or heart disease run in your family. Screening for diabetes is also commonly offered during primary care appointments, also based on risk factors such as family history and health habits.
Mental health screenings
Regardless of age, your doctor should offer you a mental health screening test. This kind of screening usually involves a series of questions about your mental state, worries and concerns, which can help your doctor get a sense of your overall well-being. This can help determine if you are suffering from anxiety, depression, thoughts of suicide or other mental health conditions. If you’re diagnosed with a mental health condition, treatment can significantly improve the quality of your life.
Primary care offices are safe spaces, and your doctor should be able to offer you tools to help you deal with your symptoms or provide a referral for additional mental health services.
Many primary care clinics have integrated behavioral healthcare care with a social worker, counselor, psychiatrist and health navigator to assist with your mental health and social support needs. Ask your doctor or clinic if this service is available.
Substance use screenings
During a routine physical exam, your primary care doctor will also ask about your smoking and substance use behaviors. This may include questions about how many alcoholic drinks you consume in a week and whether or not you use illicit drugs. It’s important to be honest about these answers, even if you feel a bit nervous; your medical doctor is there to provide nonjudgmental solutions, which might include counseling or other treatment services.
Maisterra also mentions screening for sexually transmitted infections, which can be offered during a typical wellness visit if you are at higher risk or prefer to have this done. Don’t skip this if you’ve had sex with new partners since your last visit or think you might be at risk for another reason.
The more information you have, the more help you can get with treating your symptoms and reducing your future risk.