What is an annual physical exam?

The Annual Physical

At. I.M. Well Medical, the annual physical is not the rote 10-minute annual physical that you are used to, where you are rushed in and out of an exam room. This is a thorough health and wellness consultation tailored to your individual background and wellness goals paired with evidence based medicine.

The annual exam includes a detailed personal history including any symptoms you may be currently experiencing, and past medical history including medications, diagnoses, hospitalizations and surgeries. It is then followed by a thorough examination of the body with a physical exam, monitoring vitals like weight and blood pressure, and drawing laboratory markers for different organs such as cholesterol.

So what is the physical exam?

The physical exam is basically how a physician is able to thoroughly and objectively evaluate each body part and organ.  The doctor assesses all body regions in a general way, looking for abnormalities.

For example, when an Internist is looking at a patient’s head, we are evaluating objective anatomic findings through the use of observation like examining the conjunctiva, sclera, cornea, and iris of each eye. We may use an oto/ophthalmoscope to test pupils for irregularity, accommodation, reaction and examine the pinnae and periauricular tissues of the ears.

Example of evaluation of the head. And that’s only the head!

Head

a. Eyes: Examine the conjunctiva, sclera, cornea, and iris of each eye. Test pupils for irregularity, accommodation, and reaction. Evaluate visual fields and visual acuity (cranial nerve II). Assess extraocular movements (cranial nerves III, IV, VI). Test the corneal reflex (cranial nerve V).

b. Ears: Examine the pinnae and periauricular tissues, Test auditory acuity, perform Weber and Rinne maneuvers (cranial nerve VIII).

c. Ophthalmo-otoscopy: The ophthalmoscope can now be used after darkening the room to examine the interior of the eye through the pupillary aperture. Particular emphasis should be placed on the retina, optic disc, vessels, and macula lutea. Attention must be given to the media, lens, and cornea. Keeping the room darkened, attach the otoscope head and observe the auditory canals and tympani.

d. Nose: Connect the nasal speculum to the otoscope and examine the nares, noting the condition of the mucosa, septum and turbinates.

e. Mouth: Examine the vermilion border, the oral mucosa, the tongue. Identify the salivary duct papillae. Assess the dentition for decay, repair, condition of bite. View the pharynx. Evaluate the function of cranial nerves IX, X, and XII. If appropriate, evaluate sensory divisions of cranial nerves V, VII.

f.  Face: Evaluation of symmetry, smile, frown, and jaw movement will provide information about motor divisions of cranial nerves V and VII.

Benefits of Internal Medicine

Unlike specialists, Internal Medicine physicians are not limited to one type of medical problem or organ system. If you go to a Cardiologist, they will only focus on the heart and will not integrate signs and symptoms of disease in other body parts or organ systems. We connect the dots. General internists are equipped to handle the broad and comprehensive spectrum of illnesses in all body parts and organs that affect adults, and are recognized as experts in the diagnosis and treatment of chronic illness. Internists also specialize in health promotion and disease prevention tailored to individuals based on family and past medical history.

General internists are equipped to deal with whatever problem a patient brings—no matter how common or rare, or how simple or complex. They are specially trained to solve puzzling diagnostic problems and can handle severe chronic illnesses and situations where several different illnesses may strike at the same time. 

The annual physical is a great way to check in with your health, learn about diseases to prevent in your family, get a diagnosis for symptoms you may be experiencing and ultimately to forge a relationship with a physician so that if something does come up, you already can touch base with someone who knows you, your body, and your history. You don’t have to explain your symptoms or diagnoses every time you have an appointment. Your doctor is your doctor and will get to know you and your history, so that you can stay as healthy as possible

Services

• Family medical history screening

• Physical exam

• Blood pressure check

• EKG/ECG (electrocardiogram) testing as needed

• Immunizations: Stay up-to-date on getting recommended vaccines. We will also draw titers to confirm immune status as appropriate

• Tobacco use screening

• Pre-operative examinations 

• Lifestyle audit  &  Nutritional Counseling which may include personalized stress management, exercise and diet recommendations

• Laboratory Testing may include  CBC,  General and Detailed Chemistry Profiles including liver and kidney function tests,  Cholesterol testing, Vitamin Deficiency Testing, Sexually Transmitted Infection (STD/STI) testing including HIV, Hepatitis, Syphilis.  Urinalysis with appropriate testing for gonorrhea/chlamydia, Immunization serology testing, and another testing as needed

• Screening tests (colonoscopy, mammogram, pap smear, bone density testing, and more)

• Referral to specialists and testing for annual eye, skin, and gynecological examinations (Pap smear, mammography, etc.), colonoscopy