Annual Physical

About

The physical exam is an essential part of any doctor's visit. As the physical exam continues, the doctor will use tools to look in your eyes, ears, nose, and throat. They'll listen to your heart and lungs. This exam also includes: touching, or palpating parts of your body (like your abdomen) to feel for abnormalities

Importance of Physical Exam

All adults should have a yearly physical exam, even if there are no existing health concerns. It is important that you get a full physical exam at least once a year to note any changes in your health status. A comprehensive physical exam not only gives your doctor a chance to look for warning signs of diseases and update your current medical records, but also gives you the opportunity to talk to you doctor about any physical or mental health concerns you might have. There is a list of clinical observations that your doctor should perform during every yearly exam and it is important that you know what to expect.

Types of Physical Exams

• Primary care health screening
• Third-party-requested physical exam
• Peace Corps physical exam
• Travel physical
• Women's physical exam

Primary care health screening

Many students schedule a periodic physical exam to check on their health. Primary care health screenings are covered by the student health fee and have no charge.

Third-party-requested physical exam

This is a physical examination required by a third party, usually a potential employer or a study abroad program. This type of physical is not covered by the student health fee and has an additional charge. If lab tests or immunizations are required to complete this physical, there is also a charge for those.

Peace Corps physical exam

This is a specific type of third-party physical with an extensive physical exam. It is not covered by the student health fee and has an additional charge. There is also a charge for any immunizations required to complete the exam.

Travel physical

This is a third-party-requested physical exam that is required for participation in program of study, travel, or employment abroad. The health care provider is required to complete accompanying paperwork about a student's health status. This service is not covered under the student health fee, and there is a charge. There is also a charge for any lab tests or immunizations required to complete this physical. Please note that this is different from a travel consultation.

Women's physical exams

The Women's Health Clinic provides physical exams for women with gynecological symptoms or concerns for no charge. Appointments may be made through OMNIPC.

The purpose of an annual physical exam

A physical examination helps your PCP to determine the general status of your health. The exam also gives you a chance to talk to them about any ongoing pain or symptoms that your experiencing or any other health concerns that you might have.

A physical examination is recommended at least once a year. These exams are used to:

• Check for possible diseases so they can be treated early
• Identify any issues that may become medical concerns in the future
• Update necessary immunizations
• Ensure that you are maintaining a healthy diet and exercise routine
• Build a relationship with your PCP

These exams are also a good way to check cholesterol, blood pressure, and blood sugar levels. These levels may be high without you ever showing any signs or symptoms. Regular screening allows your PCP to treat these conditions before they become severe.Your PCP may also perform a physical exam before a surgery or before beginning your treatment for a medical condition.

The physical examination is a key part of a continuum that extends from the history of the present illness to the therapeutic outcome. If the history and physical examination are linked properly by the physician's reasoning capabilities, laboratory tests should in large measure be confirmatory. The physical examination, however, can be the weak link in this chain if it is performed in a perfunctory and superficial manner. Understanding the pathophysiologic mechanism of a physical abnormality is essential for correct diagnosis and management. For instance, the failure to discriminate between and know the origin of carotid bruits and transmitted sounds of valvular origin can have critical significance.

As knowledge of disease changes, the techniques of physical examination become augmented. The astute physician constantly reviews and adds to the repertoire of techniques for physical examination.

Evaluation of the physical examination in terms of sensitivity and specificity is difficult. Interpretation of isolated physical findings is often influenced by the presence or absence of historical information and coexisting physical findings. For instance, the assessment of whether clubbing of the fingers is present or absent has significant interobserver variability and has been demonstrated to be influenced by the clinical appearance of the patient.

Several studies have attempted to look at the validity of the physical exam as a diagnostic tool. The concept of interobserver and interobserver variability has been introduced when looking at specific isolated findings. For example, judging the presence or absence of rales is more likely to be agreed upon by several observers and on repeated exams by a single blinded observer, than is the graded intensity of breath sounds. The presence or absence of ascites in patients with known liver disease has been shown to be difficult to determine when using physical exam techniques alone. The bedside measurement of forced expiratory time by auscultation however, has been shown to have a small interobserver variability in trained observers and to have clinical value in following the degree of airway obstruction.

Because of the large degree of variability in observing many physical signs, the following recommendations can be made when reporting and interpreting physical findings.

• Emphasis should be placed on dichotomous variables (i.e., presence or absence of rales) rather than on graded variables (i.e., intensity of breath sounds).
• Some physical signs (i.e., clubbing of the fingers) represent a continuum from obviously normal to obviously abnormal. Emphasis should be placed on those findings which represent the extremes rather than the "borderline" cases.
• Recognition of those physical findings which have a high degree of interobserver variability is important. Good examples of this include detection of moderate or small amounts of ascitic fluid and detection of diaphragmatic movement by percussion. These findings should be deemphasized in favor of those with better reproducibility.
• It is beneficial to use the body's "symmetry" to advantage. Differences auscultated in breath sounds between similar area of the right and left lung are far more clinically important than an overall decrease in breath sounds.

If these points are kept in mind, the physical exam will fill its proper role in the care of the patient. That is as an adjunct to a thorough history and as a way for the physician to interact physically with the patient