Dr. Tommy

Concierge Medicine Tampa Bay


WHO NEEDS A PHYSICAL?

Is a annual physical a good idea and when should I start getting one?
I meet a lot of patients in their forties and fifties who haven't 'seen a doctor in 20 years.' There is good and bad in that. Clearly if someone hasn't had to see a doctor in 20 years then that means they are healthy generally. But there is also a lot of good to be had with routine physicals. In my practice a routine physical is 45 minutes long. That includes in depth history taking, a comprehensive physical exam, review of medical data--usually blood work.

After that all the patient's questions are answered and I provide counseling for what to look for and expect in the coming year. Sometimes we turn up things that are potentially problemsome even though the patient feels fine; like a 'normal' PSA level that is rising higher than it should or an aching back that was never evaulated thoroughly and just needs adequate physical therapy.

At a minimum I usually recommend a physical sometime in the twenties for adults and then every other year in the thirties and yearly in the forties. That being said, I think a yearly physical for patients of every age would be ideal. I recommend yearly bloodwork at physicals as well to check for any subclinical abnormalities.

Many 'national' health advisory boards are ambivalent or downright dismissive of routine bloodwork saying that it is unnecessary and 'expensive.' My counter to that argument is that the bloodwork doesn't have to be expensive. In my office a full panel for a 30 year-old male would include a CBC, CMP, TSH, UA, and lipid panel. Grand total: $105, including the cost of drawing blood and processing the specimen for the lab. That same 30 year-old spends as much on a night out in South Tampa. The real expense comes when you start involving insurance companies, billing codes, time off from work to wait in the lab--none of which we do.

So who needs a physical? Each person should make their own choice, but if I think a yearly physical for everyone is a very good investment in your health.

-Tommy McElroy, MD