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January 11, 2013

STAWAR: A checkup of annual top stories

The beginning of the new year is a good time to take care of things that we have to do on an annual basis. Most doctors and patients still swear by the annual medical checkup, although some research has questioned its usefulness for essentially healthy individuals.

More than 63 million American adults visit their doctor annually for their routine medical or gynecological checkup at a total cost of about $7.8 billion. The average annual checkup lasts only 23 minutes, cost about $116, and accounts for one in 12 adult outpatient visits.

Some studies show that the actual exam isn’t very helpful in discovering problems and may lead to unnecessary testing. It is estimated that more than $350 million worth of unnecessary medical tests are performed each year according to researcher Ateev Mehrotra from the University of Pittsburgh Medical School.

The annual medical checkup to detect or prevent health problems dates back about a 100 years in the United States, although large studies in the 1960s and 1970s failed to show a significant medical benefit for patients and there has been an ongoing debate about their utility ever since.

On the other hand, the annual physical examination is a source of reassurance for many patients and an opportunity to ask about health issues that seem too trivial to schedule an entire appointment just to discuss them. Also many older adults have chronic ongoing health concerns that need to be monitored on a regular basis and the annual examination works well for that purpose. Hopefully for at least some of these people, the annual exam can also identify emerging health problems before they become too serious.

Physician and television personality Mehmet Oz says, “Let’s face it, there’s a reason your MD majored in biology instead of English — doctors aren’t always the best communicators.”

In a recent study of arthritis patient appointments, researchers found that nearly 20 percent of visits ended in a complete miscommunication about whether knee replacement surgery was recommended for the patient or not. Dr. Oz says that doctors ask their patients whether they understand what’s being discussed less than 2 percent of the time. He advises patients “to interrupt and say, “I’m confused. Can you explain that in layman’s terms?"

Since it is easy to get rattled during the examination and most of us don’t think as fast in our underwear, many authorities also recommend that you write down a list of your main issues to take with you to the examination. Research shows that it only takes doctors about 23 seconds, on the average, to interrupt their patients when they start talking, so the list can help patients maintain their train of thought.

 I tried a list once, and while I was still deciding if I really wanted to tell the doctor about some of the items, he jerked the list out of my hands and started pouring over it. I ended up with a boatload of lab tests, X-rays and considerable embarrassment. I suggest putting down abbreviations for your problems. That way the doctor can enjoy trying to guess your complaints. I had some abbreviations on my list and the doctor seemed more than pleased with himself when he said, “Hey, I know what that means.”

Preparing for your annual medical checkup can generate some anxiety. Although experts recommend telling your doctor everything, most people are cautious about what they disclose. If you complain too much about something, it sort of pressures the doctor into taking action.

The next thing you know you’re scheduled for surgery or wearing some contraption on your face every night.

My wife Diane is getting ready to go to an annual examination and she is already rehearsing what she plans to say. She wants to get her story straight. It is sort of like how news outlets put together the top stories of the year as a New Year’s feature. Your annual checkup typically involves recounting your personal top health related stories of the year. Below are some of my top health news stories of the past few years.

1. Colonoscopy results look good — health wise that is.

2. There are five factors which interfere with my sleep. When any three out of the five are simultaneously active, I have trouble falling asleep.

3. I have eaten no potatoes, bread, rice, or pasta since I saw how I looked in the Easter pictures last spring.

4. Generally I sleep like a baby ... I’m up every two hours.

5. My eye examination went fine, but I have already broken my new glasses.

6. I signed up with a fitness center and plan to start up again real soon.

7. Despite a flu shot, a pneumonia shot, zinc tablets, and gallons of orange juice, I was still sick all through the holidays and am still coughing.

8. Diane’s inability to carry anything too heavy is aggravating my old football injuries.

9. Best news yet — the garlic bologna diet seems to be lowering my cholesterol level.

10. I know there must be more, but my memory is fading fast.

— Terry L. Stawar, Ed.D., lives in Georgetown and is the CEO of LifeSpring the local community mental health center in Jeffersonville. He can be reached at tstawar@lifespr.com. Checkout his Welcome to Planet-Terry blog and podcast at www.planetterry.wordpress.com

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