Guidelines for Personal Medical Checkups
Infant through Adult
How often should a person
have a medical checkup?
The American Medical Association suggests that people have medical checkups for prevention and early detection at least every five years until age 40 and then every one to three years thereafter. One rule of thumb suggested: For individuals in their twenties -- two exams during that time period; in their thirties -- three exams; forties -- four exams. An annual health exam is recommended for most patients after age 50.
Annual PAP smears are recommended after age 35. It is always best to
work with your clinician to decide what is best for you.
What might a person expect from a medical exam?
A complete family and medical history will be taken.
The clinician should check or ask questions about the eyes, ears, nose, throat, abdominal area, swallowing, appetite, digestion, circulation and lungs. A urine specimen is used to test problems with kidneys; a blood sample, to check cholesterol, diabetes, anemia and many other internal problems.
The clinician may request additional tests, depending on age, gender, medical history and family history. A chest X-ray, EKG, rectal examination, or stress test may be suggested. The clinician may suggest lifestyle changes and call for health interventions. New patients should be quizzed about their medical history and that of close relatives. There should be a few questions about their social history.
Whom should you see?
A family physician is a good choice as they receive the most training in preventive care.
Clinicians may counsel patients about some of the following health and behavior patterns to reduce disease, injury and premature death. The list below is for ages 25 and older.
Substance Use |
Tobacco cessation. Avoid alcohol/ drug use while driving, swimming, boating, etc.* |
Diet and exercise |
Limit fat and cholesterol intake; maintain caloric balance; emphasize grains, fruits and vegetables. Adequate calcium intake (women) Regular physical activity* |
Injury prevention |
Lap / shoulder seat belts. Proper sports protection equipment. Bicycle, motorcycle helmets* Smoke detectors, safe storage of firearms in the home*, fall prevention***, set water heater 120 to 130º F*** CPR training for household members. |
Sexual Behavior |
Prevention of sexually transmitted disease. Avoid high risk behaviors.* |
Dental Health |
Regular visits to dental care provider* Floss, brush with fluoride toothpaste daily.* |
Immunizations |
The immunization schedule for children and adults will be reviewed. |
Medication |
Prescriptions and over the counter medications will be reviewed. |
* The value of clinician counseling in influencing this behavior is unproven
** This applies only to people age 25 - 65
*** This applies only to people age 65 and older |
Major Medical Screening Test Schedule |
SERVICE |
WHO NEEDS |
HOW OFTEN |
COMMENTS |
Blood Pressure
measurement
(to detect
hypertension) |
All adults. |
Periodic Screening.
Optimally once every 2 years for those with normal blood pressure |
Those with elevated blood pressure need to be under medical care. |
Cholesterol
measurement |
All adults. |
At least once every 5 years, but more frequently if total number is elevated, HDL is low, and/or you have cardiac risk factors. |
The U.S. PreventativeTask Force and some others experts recommend screening only men ages 35-65 and women 45-65, but we advise screening all adults. |
Pap Smear ( for early detection of cervical cancer) |
All women with a cervix, starting at age 18, or earlier if sexually active. |
Every year after age 35. |
Some experts advise that women who have never had an abnormal result can stop being screened after age 65. |
| Breast cancer screening (mammogram and clinical breast exam) |
All women age 40
and over. |
Annually. Medicare reimburses only for every other year. |
Other tests such as MRI may be suggested depending on risk factors. |
Colorectal cancer screening (fecal occult blood test and/or sigmoidoscopy |
Everyone age 50 and over; earlier for those at high risk. |
Occult blood test annually; colinoscopy every 3-10 years, on professional advice. |
There is still a debate about the usefulness of occult blood test. Digital rectal exam may also be done. |
| Prostate cancer screening (prostate specific antigen, or PSA test, and digital rectal exam |
|
On professional advice. |
|
Thyroid disease screening |
People over 60, especially women, should discuss with doctor. |
On professional advice. |
If you don't have symptoms, there may be no reason to be tested. |
Glaucoma screening |
People at high risk: those over 65 very nearsighted or diabetic; blacks over 40; those with a family history. |
On professional advice of eye specialist. |
Many eye specialists advise screening all adults starting at age 40 or 50. |
| Dental checkup |
All adults and children. |
On professional advice. |
Suggest checkups every 6 months. |
| Tetanus / diphtheria booster |
All adults. |
Every 10 years. |
People over 50 are least likely to be adequately immunized. |
| Influenza vaccine |
Everyone 65 and over, people with lung or heart disease or cancer, and others at high risk. |
Annually in autumn. |
Even healthy young adults can benefit and should consider getting the shot, according to a 1995 study. |
| Pneumococcal vaccine |
Everyone 65 and over, and others at high risk for complications. |
Every 5 years. |
Effective against most strains of pneumonia; lasts 5-10 years. |
| Rubella vaccine |
All women of childbearing age. |
Once. |
Avoid during pregnancy. |
| Hepatitis B vaccine |
All young adults, as well as adults at high risk. |
On professional advice. |
All newborns should be vaccinated. |
| Reprinted with permission from the University of California at Berkeley Wellness Letter, © Health Letter Associates. |
Pediatric Checkup Schedule
Pediatric well-baby visits are a critical part of childhood care. The examination is intended to assess the infant or young child's growth and development, recognize problems early and supply appropriate intervention, provide immunizations, instruct and educate the parents, and provide treatment for existing problems.
Preventive medicine is extremely important in childhood because it sets the stage for improved health and reduced disease risk as an adult. The typical well-baby visit will provide information about normal development, diet, general care, immunizations, the latest infectious diseases that are "going around," and other important advice information for parents.
Here is a recommended schedule for Well-Baby visits:
- At two weeks of life
- 1 month
- 2 months
- 3 months
- 4 months
- 5 months
- 6 months
- 9 months
- 1 year
- 18 months
- 2 years
- 2 1/2 years
- 3 years
- Each year after throughout childhood
Of course, visits and phone calls to our office should be made any time a baby seems ill or whenever the parent is concerned about a baby's health or development. A well-baby visit usually consists of questions for the parent about the infant's general health and development, followed by a physical examination. The examination includes measurements of length/height, weight and head circumference, vital signs, and a general physical examination.
Special attention is paid to whether the infant has met the normal developmental milestones. The height, weight and head circumference is recorded on a graph, which the health care provider keeps with the infant's chart. You may want to note the results of the well-baby examination in your own medical record for the baby. You also can keep your own records of the height, weight, and head circumference.
The well-baby examination is an ideal time to discuss concerns or questions with your doctor. This may include special questions you have about immunizations, nutrition, growth and development, accident prevention and family related concerns. If you have important questions, it is a good idea to write them down before going for your well-baby visit - you will save time and won't forget any of the questions you wanted to discuss.
Immunization Schedule Infant through Adolescence
Below are two schedules you can download that are recommended immunization schedules as supplied by the American Academy of Pediatrics. You must have Acrobat Reader installed to view.
