Our bodies act as vehicles, and as with most vehicles, there are maintenance schedules that, if followed, can ensure them to remain in the best possible shape for as long as possible. I like to tell my patients that we do not wait for planes to crash before tuning them up –– we check everything before even starting the engines to maximize the probability for the best outcome. No one quibbles about the cost of aircraft maintenance.
This approach can be applied to the human body as well. I’m a believer in verifying health rather than merely assuming it. and the only way to verify health is by performing regular, thorough health “maintenance.” For our bodies, the tune-up is a physical every 12 to 18 months. Over the years, I’ve developed the Reality Check Checkup, a comprehensive physical that I conduct for every patient. After more than 25 years of seeing patients, I have found that this nontraditional approach keeps my patients healthy and out of my office or the hospital.
The Reality Check Checkup includes:
- A review of health statistics and trends to see what possible health issues that particular patient might have
- The patient’s personal and family health history and his genetic predisposition
- Complete bloodwork, including blood count, chemistries, thyroid, lipids, C-reactive protein (or CRP) and prostate specific antigen test (for men age 35 and up)
- Urinalysis
- Chest X-ray (two views of the lungs)
- For women: pelvic exam, pap smear, testing for human papilloma virus, baseline mammogram after age 35 and a pelvic sonogram after age 40 (at least every other year)
Other tests should be conducted every few years:
- Colonoscopy starting at age 45 and at least every five to seven years afterward depending on findings
- Cardiac stress test and echocardiography beginning at age 45 and up, every three to five years or annually if the patient is at risk
- Bone-density testing (baseline) for women at onset of menopause and men at 60 every one to two years
- 64 slice CT-angiogram of the chest and coronary arteries periodically in those with cardiac risk factors and smokers; this test is controversial but can be lifesaving
- Advanced lipid (VAP) testing to detect small lipid particles that would not appear in routine cholesterol testing, at least every three years beginning at age 25
The goal of the Reality Check physical is to avoid being blind-sided by something that could have been detected in its earlier stages and either prevented, modified, or cured. These tests include upgrades that can provide huge values to the patient’s future health. By following this type of physical, my patients have fewer coronary problems and very few visits to the hospital.
As much as I believe in such aggressive testing, insurance companies will not always cover these tests, and doctors often succumb to financial pressures and will not always order these tests. Nevertheless, there are ways that patients can work with their doctors and health professionals to make the tests more affordable.
This maintenance schedule is not the sole responsibility of the doctor. As patients, each of us are the other half of our maintenance team, and we should not be shy about asking for or even demanding these tests. After all, it’s our health that’s at stake. And what can be more affordable in the long term than good health?
