Health The Periodic Health Examination by Robert MacMillan MD Many seniors recall the times when we all had a family doctor and had a yearly health assessment and physical examination. More than a decade ago, a number of studies showed little benefit from these routine complete physical examinations on healthy adults, and both medical bodies and provincial government insurers modified their recommendations for a more focused periodic health examination for those with certain medical conditions or strong family histories of certain diseases. A complete annual physical examination is not done routinely now for healthy individuals. For patients, especially seniors, who have pre-existing conditions, those on prescribed medications and patients who have a higher risk of developing medical conditions, it is still recommended that a focused periodic health examination be done. For seniors, the majority of us have one or more medical conditions and should be booking such an overall review of our health, usually on about a yearly basis. According to one’s age and medical status, the health assessment and physical examination will be focused particularly on conditions which one has, or is at risk of getting due to family history, toxic exposure or age. Screening tests might be indicated and arranged, such as a mammogram for women older than 40 years of age, a prostate test (PSA) for men older than 50 or blood tests such as a hemoglobin, complete blood count (CBC), electrolytes, blood sugar, cholesterol level and kidney test (Creatinine). If there is a family history or symptoms suggesting a risk of bowel cancer, a test for blood or a colonoscopy may be indicated. Patients with known chronic conditions such as hypertension, diabetes, heart conditions, anemia, respiratory conditions and others will be particularly reviewed with examination, review of progress and possibly further followup, consultation or investigation indicated. During that examination, a review of one’s immunization status should be completed and, especially for travellers, arrangements should be made for necessary shots such as Covid, influenza, shingles, tetanus and others based on travel sites. Unfortunately, with the shortage of family physicians in Canada, not only are there millions who do not have a regular family doctor to perform these examinations, there are also those who have a doctor, but are often never offered such appointments. Most family physicians have practices that have a full roster of patients and face much more pressure in treating acute medical problems and managing chronic conditions. The patient needs to pay increased attention to his or her own health, as well as that of family members. Last week, I was fixing my lawn mower with my neighbour, a retired mechanic, when I noticed a large mole on his temple. It was very dark and had irregular edges and I immediately wondered if it was a malignant melanoma. I asked him about it and he said that it had been there for many months and it seemed a bit bigger. 32 | www.snowbirds.org
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