Do I need a physical?

March 1, 2008 4:22 PM

I've never had a physical - do I need one and what would it involve?

I just started a new job, my benefits have just kicked in, and I'm thinking that getting a physical might be a good idea (dammit, my car gets one every year). When I joined my current health practice 5 years ago I had a quick weight/ blood pressure check & testicular exam, but that's all. I've never been back since except for a couple of minor issues. I'm 35 in OK health and I have a PPO.

Is this a good idea or unnecessary? How extensive are physicals (I've only seen them in the movies, and they usually involve people on treadmills with lots of sensors)? Are they expensive?

I understand that checking for a bunch of stuff that you show no symptoms of is a bit of a waste of time, but I'm assuming that knowing if my cholesterol's going through the roof or I'm heading towards diabetes (my father and his mother are/ were diabetic) would be useful information to have sooner rather than later.

posted by forallmankind to health & fitness (16 comments total)

Have a physical. It's not unnecessary. It's nowhere near extensive as you see in the movies, and there will be no treadmills, and no sensors (maybe an EKG). They should be covered in any new patient visit you sign up for at the doctors office.

It's not a waste of type. You have new insurance, it would be silly not to do it. Most likely it'll take less than 15mins, although the history part of the new patient visit should take longer than the actual physical.
posted by ruwan at 4:26 PM on March 1, 2008

90% of my last physical was nothing but talking with my doctor. He then did some things based on my answers to his questions (like he did a blood test to screen for cholesterol thanks to my relatively atrocious diet and slight high blood pressure), but it's not like he ran me through a battery of tests just for his own amusement. He did the testicular check, the height/weight, the BP, and some general reflex/eye-nose-throat checks. The whole thing took about 45 min.

Your health is like anything else - the more you know, the better off you are. Go get a physical. It's painless, it's quick, and you'll know what you need to do to take care of yourself better after you've gotten the results.
posted by pdb at 4:32 PM on March 1, 2008

Just anecdotally, I have 3 (three) friends who have had thyroid cancer detected on a routine physical. Makes me think they are a good idea.
posted by gaspode at 4:45 PM on March 1, 2008

In my non-doctor, anecdotal experience, how extensive your physical is depends on the physician. If you've never had one and you're a 35-year old male chances are you'll get a finger up your ass at the very least, which you probably should have anyway. My doc does a EKG and a chest x-ray every year (though I'm a little older than you) as well as the usual height, weight, blood pressure, cholesterol etc. I'm not a smoker and never have been, so the chest film is controversial, but he's a "better safe than sorry" guy. I'd say if you have decent insurance that covers all or most of it, get a full physical. What do you have to lose?
posted by The Bellman at 4:46 PM on March 1, 2008

Physicals as you get older are also good for establishing baselines. So, they'll know what your blood pressure/weight/cholesterol is now so that they can tell if something goes crazy in the future, or if you're feeling weird they can check to see if those things have changed. Lady physicals are a little different than for guys but generally they'll check you out, look for trouble spots, talk to you about your general health (lately in the US I've noticed a lot of paying attention to things like stress, nutrition and safety stuff more than I recall in the past) and test some basic things.

The treadmill stuff is usually for people who are getting a workup for something specific. Like if your doctor notices that you seem to be wheezy, he or she might run you through some breathing/asthma tests. If you're at risk for diabetes they might do a blood test [or a fasting blood test, whatever those are called] to check your sugar levels. I have health insurance and my physicals are 100% covered, one per year I think. I live in a rural area with a lot of people who get injured in accidents or take terrible care of themselves and my doc always seems a little surprised that I, a pretty averagely healthy person, show up every year or so just to check in.

A physical is also a time for YOU to ask questions you might have. Whether a mole is looking unusual or good suggestions of ways to deal with your cholesterol, etc. So if you can think of health concerns you might have you can bring them in and ask your doc. I think they're good for peave of mind and a good thing to get done while you're feeling pretty decent and health insurance is covering you.
posted by jessamyn at 4:51 PM on March 1, 2008

Many health insurances have preventive exams covered at 100%, so you may come out better than you think. Regardless of the cost, you should get one. There are many conditions that a physical would pick up but otherwise would not show up until it is too late to do anything about them.
posted by slavlin at 4:56 PM on March 1, 2008

Go get a physical--at least your physician will have a basic idea of who you are if you come back with another problem. It'll probably be mostly a review of your previous health issues, checking your blood pressure, perhaps drawing some blood for cholesterol and basic labs, and then an exam by your physician.

Likely most of it will be education about eating right, exercising, etc, but again, depends on your history.

If you've never had one and you're a 35-year old male chances are you'll get a finger up your ass at the very least, which you probably should have anyway.

I'll admit I didn't see many young people during my outpatient medicine training (35 is young), but unless you have a history of prostate cancer, colorectal cancer, or other GI or GU issues, I don't know that a 35 year-old physical would require a rectal exam. Some of the internists here might be able to weigh in. If they wanted to check for blood in your stool, they might send you home with some cards you poop on and send back. Heh.
posted by gramcracker at 4:57 PM on March 1, 2008

Depends on race. Black males will get the rectal at a younger age (looking for polyps) but afaik that isn't until age 40.
posted by Gungho at 5:19 PM on March 1, 2008

Common rules of thumb, applicable only when everything is normal:

prostate exam annually after age 40
the poop card annually
EKG annually
exercise stress test (that's the treadmills and sensor thing) once initially at about age 40 to establish a baseline and then every 5 years or so for screening
sigmoidoscopy and/or colonoscopy - once initially at about age 50 to establish a baseline and then every 5 years or so for screening

for you, given the family history, fasting blood sugars every three years or so

(This is all based on my observation as a non-physician.)
posted by yclipse at 5:37 PM on March 1, 2008

Is this a good idea or unnecessary?
Good idea. If nothing else, there will be a physician who's seen you before if you do eventually become ill. You might also detect some issues which wouldn't bother you until later.

How extensive are physicals (I've only seen them in the movies, and they usually involve people on treadmills with lots of sensors)? Are they expensive?
Physicals have a lot of checks in them that you won't notice, and nothing invasive. At a young age, no family history of rectal or prostate cancer, I wouldn't even say that you'd have to get a rectal exam. They'll listen to your heart and lungs, push on your abdomen, shine a light in your eyes, look in your mouth, look in your ears, check your pulses, check your feet, check your testes for lumps, check your genitals for lesions, feel your lymph nodes, check your reflexes, move your joints around, look at your spine, maybe look in your nose, make you listen to a tuning fork, feel your neck, take your blood pressure, ask you to play some silly seeming eye/neuro questions, poke you a couple places on your hands and feet to see if you feel it.

That's the summary of my school's 148 point exam, which I do in about 30 minutes.
posted by a robot made out of meat at 5:40 PM on March 1, 2008

My 93 year old grandmother says to just take aspirin and don't call the doctor. I'm not being snarky, she really does say that. She also practices what she preaches. I'm just trying to inject a little humor. I agree, getting a physical is never a bad idea. You have nothing to lose and a lot to gain, maybe even add several years to your life. Good luck.
posted by wv kay in ga at 6:05 PM on March 1, 2008

Thanks for all the answers so far. FWIW, I have had a sigmoidoscopy before, so after one of those, I'm not so worried about "the finger."
posted by forallmankind at 6:10 PM on March 1, 2008

gramcracker writes "I don't know that a 35 year-old physical would require a rectal exam."

My doc said it isn't required at that age but because there are essentially zero possible side effects besides a bit of discomfort why not have it done.
posted by Mitheral at 6:29 PM on March 1, 2008

Consider also visiting a dermatologist, too (though of course this will be more realistic if you happen to have insurance that pays for it). They're experts in finding minor moles which are or can become cancerous, and they also track changes over time.
posted by debgpi at 7:57 PM on March 1, 2008

The doctor makes you put on one of the annoying robes with no back/front, comes in, tries to make small take while she feels your breast for lumps and stick a cold metal gadget up your vagina.

oh, wait... you said, "testicular exam".... I have no experience with this particular type of appointment. All I can say is that yes, it is a good idea to get a physical, especially if you haven't had one in a while. You'll be able to establish a doctor for when something does go wrong.
I recently had a full PT exam and it was around $160. Often insurance will cover part or all of an annual exam.
Also, it is nice to have a written record of your blood pressure, etc. so that you have a "normal" reading in case you have a problem later.
posted by silkygreenbelly at 8:10 PM on March 1, 2008

It's a good idea. I just had a physical with a new doctor, and they took my blood pressure, took blood to run blood tests (cholesterol, liver function, thyroid etc.), did an EKG, did a breath test (I just had to blow really hard into a tube thingy, no treadmill required) and a general history. He also listened to my heart, checked my back, checked my thyroid size and rapped on my knees to check reflexes.

Turns out I have hypothyroidism and am now on medication to control it. So I'm pretty glad I went.
posted by bedhead at 8:58 PM on March 1, 2008