What Is an Annual Physical Exam?
The physical exam is an essential part of any doctor's visit. Surprisingly, though, there are no absolutes in a routine physical. A good doctor may be thorough or brief, but they will spend time listening to your concerns and providing counseling for your particular complaints and risk factors. Your doctor can suggest preventive steps that may keep health problems at bay.
If you have a medical issue that doesn't seem quite pressing enough to schedule an appointment, your annual physical can be a good time to bring it up. If you and your doctor catch a condition early and begin treatment, you're likely to have a better outcome.
Where to get your health screening done
You might have your screening with a doctor, a physician's assistant, or a nurse practitioner.
But what if you don't have a primary care doctor, or a regular pediatrician for your child?
Some urgent care clinics offer annual screenings.
If you're a college student, your university health service may offer annual exams. Some university health clinics offer exams even to nonstudents as a way to improve training for doctors.
A local internist or doctor in general practice might provide an annual exam even if you're not a regular patient.
You might be able to use telemedicine for an annual screening. You'd visit a local lab for tests, then review results with a doctor via a phone or video call.
Community health centers or your local public health department may offer some annual screenings, including exams and vaccinations for kids, at low or no cost.
Some pharmacy chains such as CVS and Walgreens have clinics that offer exams.
What's Included in an Annual Physical Exam?
A yearly checkup will include some discussion with your doctor about your health and certain physical exams.
History. This is your chance to mention any complaints or concerns about your health. Your doctor probably also will quiz you about lifestyle behaviors such as smoking, excessive alcohol use, sexual health, diet, and exercise. The doctor will also check on your vaccination status and update your personal and family medical history.
Vital signs. Some vital signs checked by your doctor include:
- Blood pressure: Less than 120 over 80 is considered normal blood pressure. Doctors define high blood pressure (hypertension) as 130 over 80 or higher.
- Heart rate: Values between 60 and 100 are considered normal. Many healthy people have heart rates slower than 60, however.
- Respiration rate: For a healthy adult, 12-16 breaths per minute is a normal rate. Breathing more than 20 times per minute can suggest heart or lung problems.
- Temperature: The average temperature is 98.6 F, but healthy people can have resting temperatures slightly higher or lower.
General appearance. Your doctor gathers a lot of information about you and your health just by watching and talking to you. How are your memory and mental quickness? Does your skin appear healthy? Can you easily stand and walk?
Heart exam. Listening to your heart with a stethoscope, a doctor might detect an irregular heartbeat, a heart murmur, or other clues to heart disease.
Lung exam. Using a stethoscope, a doctor listens for crackles, wheezes, or decreased breath sounds. These and other sounds are clues to the presence of heart or lung disease.
Head and neck exam. Opening up and saying "ah" shows off your throat and tonsils. The quality of your teeth and gums also provides information about your overall health. Ears, nose, sinuses, eyes, lymph nodes, thyroid, and carotid arteries may also be examined.
Abdominal exam. Your doctor can use a range of examination techniques including tapping your abdomen to detect liver size and presence of abdominal fluid, listening for bowel sounds with a stethoscope, and palpating for tenderness.
Neurological exam. Nerves, muscle strength, reflexes, balance, and mental state may be assessed.
Dermatological exam. Skin and nail findings could indicate a dermatological problem or disease somewhere else in the body.
Extremities exam. Your doctor will look for physical and sensory changes. They may check the pulses in your arms and legs and examine your joints for any abnormalities.
Male Physical Exam
An annual physical exam for men or those assigned male at birth might also include:
- Testicular exam: A doctor can check each testicl* for lumps, tenderness, or changes in size. Most people with testicular cancer notice a growth before seeing a doctor.
- Hernia exam: The famous "turn your head and cough" exam checks for a weakness in the abdominal wall between the intestines and scrotum.
- Penis exam: A doctor might notice evidence of sexually transmitted infections (STIs) such as warts or ulcers on the penis.
- Prostate exam: Inserting a finger in the rectum lets a doctor feel the prostate for its size and any suspicious areas.
Female Physical Exam
An annual exam for women or those assigned female at birth might include:
- Breast exam. Feeling for abnormal lumps may detect breast cancer or benign breast conditions. The doctor will also check the lymph nodes in your underarm area and look for visual abnormalities in your breasts and nipples.
- Pelvic exam: The pelvic exam allows examination of the vulva, vagin*, cervix, uterus and ovaries. Routine checks for STIs are often done. A Pap test and HPV test can screen for cervical cancer and help assess risk.
Annual Physical Exam for Children
Your child's annual exam might include:
Immunizations. The doctor will make sure your child's vaccinations are up to date and provide any that are needed.
Growth. The exam will check your child's height and weight to make sure their development is in line with expectations for their age.
Blood pressure. Your child's blood pressure will be taken.
Vision and hearing. The doctor may check your child's eyesight and hearing, and refer you to a specialist if needed.
Physical exam. The doctor will look at your child's skin and listen to their heart and lungs. They may check your child's back for curvature of the spine. A parent or caretaker should always be present during this part of the exam.
Depression. Some doctors routinely ask questions -- especially as kids enter puberty -- to screen for depression.
Questions and answers. The doctor may ask about sleeping, eating, exercise, and other activities. The doctor also will discuss any questions you or your child have about their health or development.
Laboratory Tests During Physical Exams
There are no standard laboratory tests during an annual physical. However, some doctors will order certain tests routinely:
- Complete blood count
- Chemistry panel
- Urinalysis (UA)
However, unless symptoms already suggest a problem, these tests are unlikely to provide useful information.
A screening lipid panel (cholesterol test) is recommended every 4-6 years, according to the American Heart Association. Your doctor might check more frequently if you have risk factors for heart disease. Abnormal cholesterol levels increase the risk for heart attacks and strokes.
If you're overweight or have any risk factors for diabetes, your blood sugar probably will be checked. The American Diabetes Association recommends that all adults, beginning at age 45, should be tested for diabetes -- regardless of weight.
The CDC recommends that everyone over the age of 18 get screened at some point for hepatitis C. This may happen during one of your physicals.
The Importance of Prevention and Screening
The annual physical exam is a great opportunity to refocus your attention on prevention and screening:
Colorectal cancer screening. At age 45, it's time to begin regular screening for colorectal cancer. People with immediate family members with colorectal cancer or other risk factors may need to be screened before age 45.
Breast cancer screening. For some women and those assigned female at birth, age 40 marks the time to begin annual mammogram screening for breast cancer. The American Cancer Society recommends that those aged 40-44should have the choice to start mammograms if they wish to do so. If you are 45 to 54, youshould get mammograms every year. If you're 55 or older, you can switch to mammograms every 2 years or can continue yearly screening. Talk to your doctor or other health care professional about when to start and how often to get a mammogram. There are different guidelines for breast cancer screening depending on your risk for breast cancer and whose guidelines you choose to follow. Weigh thebenefits and risksof screening tests when deciding whether to begin getting mammograms at age 40.
Healthy behaviors work far better than medicine at preventing illness and don't require a prescription:
Exercise. Do 30 minutes of brisk walking or other exercise most days of the week (or about 150 minutes a week). And add in some strength training at least twice a week. Your risk for cardiovascular disease, diabetes, and some types of cancer will fall dramatically.
Diet. Eat a mostly plant-based diet, low in animal fats.
Tobacco. Above all, don't smoke.
Preparing for Your Annual Physical Exam
You can steps to make sure you get the most out of your yearly physical.
Make notes. Write down questions you have for your doctor or any concerns you'd like to discuss and take the list with you. This will help you make sure you cover everything you want to know.
Know your medical history. Has anything changed since your last exam? Let your doctor know of any procedures or immunizations you've had in the last year. Have you received a diagnosis of a new condition from another doctor? Be sure to mention that.
List your medications. Have a record of all the medications you take, including the dose. This may include medicines prescribed by other doctors. If you use over-the-counter drugs or supplements, let your doctor know about those, too. It's important for your doctor to know about everything you are taking.
Schedule other appointments. It might be helpful to schedule your mammogram, blood work, or other tests before your appointment for your exam. If you have your results, you and your doctor can review them in person.
Other health data. If you monitor your blood pressure or blood sugar levels, use a symptom tracker, or keep a health diary, bring that information with you. It will help your doctor get the best understanding of your health.
Dress in comfortable clothes that you can change out of easily if your doctor wants you to put on a medical gown for your exam.
Do You Even Need an Annual Physical Exam?
Many people and their doctors prefer the annual physical exam. But studies show that the actual exam isn't very helpful in discovering problems and may lead to unnecessary tests.
Leading doctors and medical groups have called the annual physical exam "not necessary" in generally healthy people.
Exercising, keeping a healthy weight, and not smoking are enough to keep most of us in good health, with or without an annual exam. Still, no one can argue with keeping up a good relationship with your doctor through regular visits. As long as you and your doctor are paying attention to prevention and your overall health, the choice is yours to make.
Annual Physical Exam Cost
How much you'll pay for an exam depends on what type of health insurance you have, if any.
When checking your benefits, it's important to understand the terminology your doctor's office and insurers use. You may hear the term "annual physical," "annual exam," "routine exam," "checkup," and "annual wellness visit." For children, you may hear the term "well-child visit." They may sound like they're all the same thing, but there are differences. Your insurance company can clarify what's covered and what isn't.
If you have Medicare Part B, you're entitled to a one full checkup at no cost during your first year of enrollment, sometimes called your "Welcome to Medicare" visit. After that, Medicare covers a "wellness" exam each year. These appointments focus on preventive care and are not the same as an annual physical exam. There's no deductible or copay for the wellness exam. Medicare also covers some immunizations and screenings without a copay or deductible, but you may have to meet an age requirement or risk threshold.
The Affordable Care Act requires that most health insurance plans cover certain vaccinations, screenings, and preventive services at no cost to you. You'll have to follow your insurer's rules about which providers to use.
Medicaid is run by state governments, and the benefits vary depending on where you live. However, if your child is covered by Medicaid, the Affordable Care Act does require that certain types of care are covered. Medicaid has a website where you can check your state's specific coverage.
What Happens After Your Annual Health Screening?
Once you've had a yearly exam, you should receive information from your doctor summarizing your visit. This could be a printout, or your doctor might send it via an electronic patient portal. Topics covered by the summary may include:
Health goals and expectations. This might include targets for your cholesterol, weight, or blood sugar, for instance.
Guidance. You might receive tips about reaching your health goals or managing chronic conditions.
New prescriptions. If your doctor has ordered a new prescription or changed your dosage of an existing one, you'll receive information about that.
What you need to schedule. You'll get information about tests, screenings, or vaccines you'll need in the future. If you have a referral to another doctor for care focused on a specific issue -- for instance, an orthopedist or neurologist -- that will be noted, too.
When to come back. The doctor should let you know when you need to schedule follow-up care or your next annual exam.
Takeaways
The annual physical exam is something you can do to maintain your health, but experts differ on whether they're necessary for healthy people. The annual exam is a chance to discuss any concerns with your doctor, see how well you're managing any chronic conditions, and set health goals. It also may include routine screenings such as blood tests. It helps your doctor understand the big picture regarding your health. If you don't have a primary care doctor, you may be able to get an annual exam at a clinic in your pharmacy, a community health clinic, or your public health department. What you'll pay depends on the type of insurance you have, but the U.S. government requires most health plans to cover some preventive health measures, screenings, and vaccines at no cost.
Annual Physical Exam FAQs
What's the difference between an annual physical and a wellness exam?
The terminology can be confusing. A wellness exam focuses on maintaining your health and preventing future illnesses. If you've got a specific complaint -- your shoulder hurts, or you're worried about your blood pressure -- don't expect your doctor to deal with it during a wellness exam. A wellness exam also won't focus on managing chronic conditions such as diabetes or heart disease. It's about making sure you're getting all the screenings and vaccines you need to stay on top of your health.
What are some normal physical examination findings?
You should come away from a physical exam knowing your height, weight, and blood pressure. Blood tests may check your cholesterol level and other numbers.
Can you eat or drink before a physical exam?
If you're having blood work done, your doctor will tell you to fast for a certain number of hours before the tests.
What are the four types of physical examination?
An annual exam might include these types of checks:
Inspection. Your health care provider looks over your body.
Palpation. Your health care provider feels parts of your body with their hands, for instance, your abdomen.
Auscultation. This means listening to your body, probably with a stethoscope. This can include checks of your heart, lungs, and abdomen.
Percussion. Your health care provider creates sounds by tapping on various parts of your body.
