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Take an active role in your physical exam: be proactive and inquisitive to build a rapport with your doctor and benefit from preventive health evaluations.

Physical exams are a status report on your health, an evaluation of what you need to do to avoid or manage chronic diseases.

But in an analysis published in October 2012 in the Cochrane Database of Systematic Reviews, researchers concluded that although general health checks led to a rise in the number of new diagnoses of chronic conditions such as cardiovascular disease and cancer, they did not reduce morbidity or death from these disorders.

Nevertheless, a Cleveland Clinic expert says preventive health assessments are valuable, particularly when focused on a patient's individual needs. And, men can benefit the most if they take an active role in their care and their physical exams.

"I hope this study doesn't drive men to say, 'I don't need to see my doctor." says Raul Seballos, MD, vice chairman of Cleveland Clinic's Department of Preventive Medicine. "Physical exams are a good way to build that doctor-patient relationship and build better adherence to recommendations and guidelines. And better adherence may lead to better outcomes."

GET CHECKED

A patient recently visited Dr. Seballos for a routine exam. Tests showed he had an elevated white blood cell count, and he was diagnosed with acute leukemia, which had developed in the year since his previous physical exam. "We have these anecdotal findings that demonstrate that there is value to a physical exam," Dr. Seballos says.

Yet, men are 24 percent less likely than women to have visited their doctor within the past year, according to the U.S. Agency for Healthcare Research and Quality.

Men who are otherwise healthy and have no weight or blood pressure issues generally can wait one to three years between physical exams, Dr. Seballos recommends. Others, particularly men with chronic medical conditions or risk factors, should see their doctor yearly or more frequently, he says.

As part of your general physical exam, your physician typically will do the following:

* Inquire about your family and personal medical history, as well as your vaccination history.

* Provide counseling about exercise, nutrition, alcohol consumption and, if necessary, tobacco cessation.

* Screen for obesity by measuring your height, weight and, possibly, your waist circumference.

* Measure your blood pressure and check your heart and lungs.

* Check for problems in your eyes, ears, nose, and throat.

* Perform a full-body skin exam to check for skin cancer.

* Discuss screenings for colorectal, prostate, lung and other cancers, abdominal aortic aneurysm, depression, and, in some cases, sexually transmitted diseases.

Your doctor also may order tests for cholesterol and diabetes, and perform a cardiovascular risk assessment.

"A good history and physical exam should take about 45 minutes," Dr. Seballos says. "A physical exam scheduled in 15 to 20 minutes is pretty cursory."

Your exam should focus on your individual characteristics, he adds. For example, if you have diabetes, your doctor will address your blood sugar, nerve and ocular complications, and may ask about erectile dysfunction. If you have arthritis, your physician may concentrate on your balance and risk of falls.

"The exam has to be more focused," Dr. Seballos emphasizes. "One man may have different needs and concerns from the next guy who sees me in the next hour. We focus on each one's risk factors based on his lifestyle, medical conditions, and family history."

OPTIMIZE YOUR TIME

Go into your physical exam with a game plan. Before your appointment, send your doctor a list of your family and personal medical history, your immunization history, and the medications or supplements you take. Outline any specific concerns you want to address.

Dr. Seballos also recommends asking about undergoing any necessary lab tests ahead of time: "If I'm seeing a patient and I haven't had any blood work on him in the past year, sometimes I can order the tests in advance so we have the results by the time he sees me. That's the ideal situation, of course, but not always possible."

Bring a list of questions, and discuss your top two or three concerns early during the visit. If you run out of time, schedule a follow-up appointment, or arrange to speak with the doctor or a staff member later. (For more tips, see What You Can Do on Page 3.)

Most importantly, be forthcoming with personal information.

"Don't hide under the covers if you have a certain issue," Dr. Seballos advises. "If there's really a health concern, bring it up early. That's why it's important to build a rapport with your doctor and develop that doctor-patient relationship. Sometimes my exam room becomes like a confessional."

RELATED ARTICLE: WHAT YOU CAN DO

During your physical exam:

* Speak honestly about your lifestyle and any health concerns you have, even if it makes you uncomfortable.

* Ask questions. If you stay silent, your doctor may think you understand everything.

* Take notes to help you remember what you've discussed with your physician.

* Consider bringing someone along to help you ask questions or take notes.

* Ask your doctor for written instructions or any educational materials that can help you.

* Have your doctor carefully outline any health-improvement goals you may need to achieve.
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Title Annotation:GENERAL HEALTH
Publication:Men's Health Advisor
Date:Mar 1, 2013
Words:841
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