Most physicians advocate tailoring the frequency according to your personal & family history of medical problems. After age 50, everyone should get annual physicals. Those with heart disease, diabetes, and/or a family history of some cancers (colon, breast, prostate) may need to start annual physicals as early as 35 years old.   

You should have at least two physicals during your 20s. Your height and weight will be checked, which will be used to calculate your BMI (body mass index) – a BMI over 25 is a warning sign that means, if you don’t improve your diet & exercise, you will be at risk for future problems such as diabetes, heart disease, chronic low back pain, chronic arthritis of the knees, hips, ankles & feet, and even some cancers (colon, breast). Blood pressure will be checked, and diphtheria/tetanus boosters may be given (every 10 years). We will concentrate on your lifestyle during these visits. Your most significant risks for death & serious disease are due to accidents (motor vehicle accidents due to alcohol or recklessness), alcohol/drugs, and sexually transmitted disease. Use of seatbelts and safe sex procedures will be stressed. Regular surveillance for HIV, hepatitis B & C, and syphilis will be done. If you smoke, drink excessive alcohol, or use drugs, you will be strongly counseled to stop. The importance of regular exercise will be stressed - at least 3 ½ hours per week of aerobic, core, and strength training.

A baseline cholesterol profile will be done, including total cholesterol, triglycerides, HDL (good cholesterol), LDL (bad cholesterol), and ratio (total divided by HDL). High triglycerides in combination with a low HDL means you are at risk for diabetes and you need to take immediate action to improve your lifestyle. A LDL over 130 is particularly bad if you have a family history of heart disease.

Women need to get annual PAP smears with screening for HPV (human papilloma virus) and Chlamydia when they become sexually active.

Men need to be screened for testicular cancer between 18 and 40 years of age. Self exam will be taught & encouraged, as will safe sex and screening for STDs.

Most people in their 30’s & 40’s enjoy relatively good health even with bad habits. Complete physicals in this age group will continue to be every 3-5 years, though more frequent exams may be recommended if you have a family history of heart disease, diabetes, or certain cancers. You will be seen more often if you are overweight because diabetes, high cholesterol, high blood pressure, and sleep apnea will start appearing this early, even if you are feeling good. These conditions will cause you a lot of problems as you get into your 50’ & 60’s if they are not corrected early on. Regular exercise and a healthy diet need to be strongly encouraged in this group – they are young enough & wise enough to understand they need to develop these healthy habits early on.

The 40’s can be a time of major change for those who haven’t heeded our advice up to this point. If you are overweight and don’t exercise, you probably have diabetes and high blood pressure by now, and you may have sleep apnea. If you smoke & have a family history of heart disease, there is a good chance you already have significant blockages, putting you at risk for a heart attack or stroke. Those with these risk factors should get annual exams. You will probably be recommended to get a stress test. Women over 35 who smoke must not be on birth control pills due to the very high risk of strokes. Those who follow a healthy lifestyle can continue exams every 2-3 years. Screening for prostate cancer starts at 40. This is especially important for African-Americans, who are at higher risk for early prostate cancer. Women should have a baseline mammogram by age 40.

In the 50’s, screening for heart disease and cancer becomes more intensive and everyone should be getting annual exams by now. Healthy lifestyles will continue to be stressed, especially a healthy diet & adequate exercise. Those with a family history of heart disease before age 60 will need a stress test. Colon cancer screening by colonoscopy starts at 50, even with no family history. Those with a close family member with colon cancer before age 65 will be recommended for earlier screening. Women need annual mammograms starting at age 50. Those with a family history of both breast and ovarian cancer may need additional testing, such as a pelvic ultrasound or testing for the BRCA gene.

In the 60’s, surveillance continues on an annual basis. Regular exercise will be stressed to preserve mobility, prevent arthritic pain, prevent osteoporosis, and preserve a general feeling of well being. You will be screened for depression and stress that can start occurring about now as you get ready to retire and perhaps are dealing with your own or a relative’s life stresses.

In the 70’s and beyond – surveillance is more dependent on your own past medical history and lifestyle than your family history. Treatment is tailored according to your personal history. Continued encouragement will be provided regarding exercise & a healthy diet.