Psych physical Exam

Here’s how I try to make my annual physical exam as worthwhile as possible.

All year

Every time I have a question or concern that doesn’t require immediate attention and that I can’t more validly get from the internet, I write it in a word-processing file named “Doctor.” Usually, they’re questions that require a personalized response—for example, “Dr. Jones, in my case, do you think I should switch from a PPO to an HMO?”

A month before

I email my long-time and trusted physician, John T. Jones, requesting a requisition for the blood and urine testing needed for my exam. When I receive it, I attach it to my calendar for one week before my exam.

A week before

I viscerally start to worry: “Everyone is only one blood test away from a death sentence.” As soon as such evil thoughts enter my brain, I distract myself by getting involved in my work, household chores, whatever.

I get my blood and urine work done at least a few days before my exam. It usually only takes a day for the results to get to my doc but I wouldn’t want some bureaucratic screw-up to prevent him from having my results during my exam.

The day of

That morning, I go through a series of structured thinking to add items to ask John about: Head to toe, wake to sleep, weekends. I then review all the questions. He’ll only have so much time to address my questions. So, if it’s something I could email him about or I conclude is unlikely to yield something that would significantly improve my health, I delete it.

At the exam

When Dr. Jones first walks in to the exam room, I don’t just ask the obligatory, “How are you?” In past years, he has told me a few things about his life, so I make a point about asking him about at least one of those. That quietly reminds him that I value him not just as a physician but a person.

I don’t start by asking my questions. I respect that he has his process: Review my electronic medical record, report the lab test results, and ask me some questions. Then, when he asks me if I have any questions, I ask them. If I’m not satisfied with his answer, I’m not afraid to ask a follow-up or to offer an alternate approach. For example, when I asked him if I needed to lose weight and he said “No, maybe five pounds.” I said, "Would there be any health benefit to my losing 15?” He said, “Well you then might be able stop taking that blood pressure pill.” I’m glad I asked the follow-up.

At the end of the exam, he gave me a thumbs up and said the magic words, “See you in a year.” With people of my age, 64, often having health issues requiring more frequent doctor visits, I left so happy and grateful to the Fates. May your wellness exams go as well. Preparing for it certainly can help.