Have you seen your primary care doctor recently? If the answer is no, you’re not alone. The number of primary care visits in America declined by 2% between 2012 and 2016, with some patients opting for urgent care or virtual care to address their serious medical problems.
But visiting your primary care doctor, nurse practitioner or physician assistant for a regular appointment based on your age and risk factors is still important.
According to Dr. Nina Maisterra, a family medicine physician and clinic chief at UW Neighborhood South Lake Union Clinic, seeing your primary care doctor on a regular basis is vital to maintaining your health and preventing possible health problems. And the frequency with which you need to go may vary based on your age and individual risk factors.
Maisterra says screenings, in particular, 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, more challenging problems.
“Early prevention and early detection can improve health and survival,” she says. “Ask to discuss with your provider what screenings are appropriate for you based on age, risk factors, family history and personal preference.”
These regular screenings help your primary care doctor get a sense of your overall health risks and current status of any mental, physical and emotional health issues. Here are six important ones to ask about at your next routine exam.
Flu shot and vaccines
Did you get your flu shot this year? If not, you should — even if you’re healthy.
According to the Centers for Disease Control, nearly 80,000 Americans died during the 2017-2018 flu season, more than any of the previous 40 years. Hospitalizations and illnesses last year also hit a record high. But only 37% of adults got their flu shot.
This year, don’t let yourself be part of that “down for the count, sick with the worst flu ever” crew. Ask your doctor for a flu shot. (It’s usually covered by insurance.) 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. 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 important screenings are mammograms, colonoscopies, cervical cancer screenings and skin cancer screenings.
Most women should get a Pap smear starting at age 21, and then every three years after that, Maisterra says. Pap smears screen for cervical cancer, which is treatable if it’s caught early enough. If your Pap smear comes back as abnormal for any reason, your doctor may suggest more frequent screenings or another procedure like a colposcopy. A newer test looks for the presence of human papilloma virus (HPV), which can lead to cervical cancer. That said, be sure to check with your doctor as these recommendations can vary based on your individual health issues.
If you’re at average risk, colonoscopies are recommended for adults starting at age 50. Colonoscopies are typically used to screen for colon cancer, but 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 this screening every 10 years; if you have high-risk factors, such as the symptoms listed above or adenomas (abnormal growths) on your first colonoscopy, your doctor might suggest scheduling them more frequently. Again, it’s important to check with your doctor to see what recommendations are right for you, as some people will need earlier or more frequent testing.
A mammogram is also recommended for women starting at age 50, although some women might need or prefer to get screened in their 40s or earlier based on their personal risk. If you have a history of breast cancer in your family, this might be a reason to talk to your doctor about getting a mammogram sooner rather than later. If everything looks relatively normal, you should continue to get a mammogram every one to two years after the first one.
During each appointment, your doctor may also ask if you’ve noticed any unusual spots, moles or changes in your skin; if you have a family history or personal history of skin cancer; or if you’ve had significant sun exposure in your life. If so, this can help determine if you need further testing for skin cancer.
Heart health is key to your overall wellness, which is why most doctors recommend undergoing a set of tests during many of 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.
People of all ages will likely undergo a body mass index, height and weight check at every physical exam. 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 your family has a risk of heart disease, if you’re obese or have diabetes, or if you’ve had high numbers on previous screening tests. Screening for diabetes is also commonly offered during primary care appointments based on your age and other risk factors.
Mental health screenings
Your doctor should screen you for depression and suicidal thoughts regularly, no matter your age. This kind of screening usually involves a series of questions about your mental state, worries and concerns, and can help your doctor get a sense for your overall well-being. If you're diagnosed with depression, treatment can significantly improve the quality of your life.
You can also talk to your doctor about any other mental health problems you might be experiencing, like anxiety. 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 those who need additional help.
Many primary care clinics have integrated behavioral health services 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 for you.
Substance abuse screenings
Your doctor will also ask about your smoking and substance use behaviors during a routine physical exam. This may include questions about how many alcoholic drinks you consume in a week and whether or not you use illicit drugs. Depending on your answers, your doctor may recommend counseling or other treatment services.
Maisterra also mentions screenings for sexually transmitted infections, which are usually offered during a typical wellness visit. Don’t skip this if you’ve had sex with new partners since your last visit or you think you might be at risk for some other reason. The more information you have, the more help you can get with treating your symptoms and reducing your future risk.