Why Get a Physical?
I was torturing myself the other day and reading reviews of my practice. Not my concierge practice but the regular medical clinic. The biggest criticism seemed to be in the younger people who objected to having a yearly physical because they felt well. Our insistence on the physical seems to erk them quite a bit. Let me take a minute to defend this idea.
I don’t know what happens when you have a physical but I believe that you should visit with your doctor at least once a year to review your health even if you feel well. Many people feel great just before their cancer diagnosis. Many people feel fine just before their heart attack. It’s not how you feel it’s what the tests show. You can feel fine and have a blood sugar of 250. You can feel completely right as rain and have a terrible Omega 3/6 ratio, high insulin, high oxidized LDL all of which are increasing your risk of a heart attack, cancer, stroke, dementia, diabetes and real failure. It’s nice to feel good but that doesn’t mean you are healthy.
So I think there is a benefit of meeting with patients at least once a year to review their vitals, what’s going on with their weight, are they gaining muscle? Are they gaining fat? Are they getting good sleep? What’s going on with their exercise? I think that once a year a visit makes a lot of sense to me to look at your habits and your lifestyle and make sure they can’t be tuned up. Also, at this visit your doctor should be able to review with you any new testing that’s available and there are new tests available all the time. There are new tests for heart disease. There are new tests for diabetes. There are new tests for memory loss. and if you don’t go to the doctor how would you find out about these tests? Blood work can tell you a lot about your basic health. I don’t care what your blood type is but I do care what your triglyceride to HDL ratio is, I do care what your Omega ratio is and I do care about your insulin level because all of those are markers of inflammation. Inflammation drives diseases including diabetes, heart attack, cancer, stroke, dementia and renal failure.
So you’re a young person and you’re not taking a lot of medicines and you don’t need a lot of tests designed for an older population. These are the patients I try to focus on their lifestyle and review with them that their food and supplement choices made when they are young affect their longevity and overall healthspan. Many of my younger patients have poor mental health, a lot of anxiety and depression especially since the covid-19. Mental health is as important as physical health and maybe more important in this age group
I often use the analogy for patients that I want to try and find the problem early. Is it better to get on your case when you put on 10 lbs. or wait until you put on 50 lbs.? Is it better to discuss your sleep apnea before or after the car accident? The analogy I use is putting out a fire. I would rather put out the fire when it’s in the waste basket and I can use a regular fire extinguisher rather than when the whole house is burning down and the fire extinguisher is not going to help much. To make a different analogy, you have your oil changed in your car not because the car is running roughly but because this routine maintenance is good for the extending of the life of your engine.
So, I recommend an annual checkup where your diet, your sleep, your exercise and your stress can all be addressed. Any urgent care clinic can handle your sore throat. Your primary doctor should be working on your overall health and guiding you to be your best and healthiest self and re-evaluating you over time to measure your success. A lot of people just take their health for granted and then when something goes wrong it’s usually much more expensive and more difficult to try and put it right than if they’d been evaluating it over time all along. The medical profession is quite happy to take your money regardless but I think it’s a vast difference in outcomes depending on when the problem is found. I don’t think it makes much difference to the doctors. We will take your money either way but it might make a very big difference to your life and your life expectancy. Until next month…get well and stay well.
JT BARRY MD
