Men's Health

How to Maximize Your Doctor Visit



Getting a physical exam before the holidays can lower stress — which itself leads to better health.

You’ll want to find out about any problems that could put a damper on family fun and festivities before the holidays, especially as many of the most serious ones don’t cause symptoms until a crisis arises. Besides, most insurance companies cover the cost of an annual physical; this health and wellness exam includes necessary vaccines, a blood-pressure check and basic lab work.

In 2004, an article called "'The Merry Christmas Coronary' and 'Happy New Year Heart Attack' Phenomenon" in the American Heart Association journal Circulation noted a 33 percent spike in deaths from heart attack in December and January. Just making sure to get a flu shot could lower the chances of heart attack by as much as 21 percent, according to findings from a Canadian study published in the medical journal The Lancet in October 2009: catching the flu increases the possibility of a heart attack, so it’s important to discuss risk factors with your doctor and take action.

According to Foundations of Wellness at the University of California, Berkeley, 44 million Americans are still without health insurance, and over half of Americans neglect their physical exam — all the more reason to buck the trend with preventive screening tests that can save money (and suffering) in the long run. Preventive screening exams are covered by health insurance and Medicare, but even without insurance an annual physical is cost effective and well worth the small investment in time and money.

Before the visit

To make sure you get the most out of your physical exam, your doctor needs to know a bit about your family history and lifestyle habits. Sharing personal information can be difficult, but talking openly will help your health-care provider to make better decisions about what testing and examinations are necessary — sometimes doctors forget to ask.

In fact, discussing what you eat, drink and smoke, your activity level, favorite hobbies, and the health of your family members can lead to fewer tests and exams instead of more. Some preventive screenings are unnecessary from or until a certain age, but much depends on individual lifestyle habits and hereditary risk factors.

Prepare for your checkup

Gather information about any tests performed in the last five years — it will save time, money and unnecessary lab work answering questions that might already have been addressed. Bring your results with you to the doctor’s, or have them forwarded before your appointment. Keep a list of past vaccines and have the nurse or technician document them for future reference.

The Health Behavior News Service (HBNS) also suggests getting to know the office staff. This can, for example, save the embarrassment of mistakenly sharing personal information with a technician — so be alert to who is doing what and ask the staff who they are.

Ultimately, getting the most out of your physical exam means being prepared to ask questions and understanding how to obtain the right answers. According to HBNS editor Lisa Esposito.

“Patients often report emerging from medical appointments feeling embarrassed, frustrated or intimidated. As they’re shuttled from the reception area to the exam room to financial records, they encounter lots of personnel, but don’t know who anyone is or what they do. After their appointments, they feel clueless about who to call for lab results or with follow-up questions.”

Health insurance: what's included

Medicare recipients are entitled to a one-time "Welcome to Medicare" physical within the first 12 months of signing up. The cost this year is 20 percent of the amount of the exam, but beginning in January 2011, annual checkups cost nothing as long are your doctor accepts Medicare.

Ask about a tetanus-diphtheria booster that’s also included as part of the new health-care benefits: You should have one every 10 years, with a 5-year boost for a puncture, wound, animal or human bite, or laceration caused by a rusty or dirty object. Other covered vaccines include the seasonal flu shot — and, for patients over 65, a pneumonia vaccine once every 5 to 10 years (this can prevent hospitalization from community-acquired strains of most bacterial pneumonia). You should also bring up the Hepatitis B vaccine, which is now recommended for all young adults.

Cancer screenings (now included as part of the health-care reforms) are included in your yearly physical exam; these include fecal occult blood testing, colonoscopy (depending on age and family history), PSA (prostate-specific antigen for prostate cancer), and basic lab testing.

How to get a cost-effective physical without insurance

If you’re uninsured or underinsured, it’s still possible to get a physical exam without incurring major expense. Physicians are happy to accept self-paying patients, and a simple discussion with the billing office can facilitate a manageable payment plan. After all, it’s hard to put a price on peace of mind.________________________________________________________________________

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Physical exam basics

After the usual blood-pressure and heart-rate check, your doctor will take down your medical history. Try to remember if anything has changed in your family history: a newly diagnosed diabetic brother; a parent with heart disease. Discuss any over-the-counter supplements you may be taking. Share any symptoms of illness, even if they seem minor.

The next — and most important — moments of a physical exam are when your doctor looks, listens and feels. Expect some level of embarrassment. The dreaded prostate exam reveals much about the size of the gland, which should approximate a walnut: anything larger might mean more testing. Black men and those with a family history of prostate cancer should have a digital prostate exam and PSA testing from age 40, per recommendations from the U.S. Preventive Services Task Force; for white men and those without a family history, the starting age is 50.

PSA testing remains controversial — discussing the risk and benefits with your health-care provider is the only way to make an informed decision. During a digital rectal exam, your doctor is checking for any irregularities in the normally smooth prostate gland that could signal tumor growth. He or she can also check a stool sample for blood — a possible sign of colon polyps, cancer or other bowel disease.

Get tested

Colon cancer screenings are recommended from age 50, and include an annual fecal occult blood test, sigmoidoscopy every five years and colonoscopy every 10 years, unless risk factors mandate more frequent screening. Cholesterol screening is key to assessing for heart-disease risk. If your LDL (low-density lipoprotein; bad cholesterol) is high or HDL (high-density lipoprotein; good) cholesterol is low, you may be at risk for heart disease.

Diabetes testing is important for men over the age of 45, and for those with a family history of the disease. It should be performed every three years. Men of any age at high risk for STIs should be checked for chlamydia, gonorrhea, HIV, and syphilis.

Check your insurance policy for co-payment costs. Many insurances policies require zero out-of-pocket expense for lab work at a freestanding laboratory or hospital (as opposed to the doctor’s office) — a great way to save money. Ask your doctor for a prescription to take to the hospital or lab, which will then forward the results to the doctor’s office.

A physical exam at the end of the year could become a holiday tradition; it’s also an easy way to remember when you’re due for one. Prevention of disease has become a primary focus for third-party payers and savvy consumers: Now it’s easier than ever to stay on top of your health because most preventive screenings require no out-of-pocket expense.

Be prepared to make the most of your physical exam by communicating well with your health-care provider, writing down questions and understanding the basic tests needed to prevent potentially devastating diseases — and enhance your holidays with the peace of mind associated with good health and self-empowerment.Find out how to get the most bang for your buck during your annual checkup