The Annual Physical: What Should Actually Happen

The annual physical examination is one of the most important appointments on your healthcare calendar, yet many people aren't sure what should actually happen during this visit. Understanding the components of a comprehensive physical exam empowers you to ensure you're receiving thorough preventive care and helps you make the most of your time with your healthcare provider.

What Is an Annual Physical?

An annual physical, also called a wellness visit or preventive care exam, is a comprehensive check-up focused on maintaining health and catching potential problems early. Unlike sick visits where you see your provider for a specific complaint, the annual physical takes a broader view of your overall health status.

The exam serves multiple purposes: establishing baseline health measurements, screening for common health conditions, updating preventive care like vaccinations, reviewing your medications, and providing an opportunity to discuss health concerns or lifestyle factors that affect your wellbeing.

The Key Components

Health History Review

Your provider should begin by reviewing your medical history, including any new symptoms, changes in existing conditions, hospitalizations, or new medications since your last visit. This is also the time to update your family health history, particularly if a close relative has been diagnosed with cancer, heart disease, diabetes, or other hereditary conditions.

Be prepared to discuss your lifestyle habits, including diet, exercise, sleep patterns, stress levels, alcohol consumption, tobacco use, and recreational drug use. While these questions may feel personal, honest answers help your provider give you the best possible care and tailored health recommendations.

Vital Signs

Every physical exam should include measurement of your basic vital signs. Blood pressure is checked to screen for hypertension, a major risk factor for heart disease and stroke. Your heart rate and breathing rate provide information about cardiovascular and respiratory health. Temperature readings help establish your baseline and can detect fever if present.

Height and weight measurements are taken to calculate your body mass index (BMI), which, while not a perfect measure of health, helps assess weight-related health risks. Some providers may also measure your waist circumference, as abdominal fat distribution is associated with certain health risks.

Physical Examination

The hands-on portion of the exam typically includes several components. Your provider will examine your head, eyes, ears, nose, and throat, checking for abnormalities and assessing your vision and hearing. They'll listen to your heart for irregular rhythms, murmurs, or other abnormal sounds, and listen to your lungs to assess breathing and check for issues like wheezing or crackling.

An abdominal exam checks for tenderness, enlarged organs, or abnormal masses. Your provider will examine your skin for concerning moles, rashes, or other changes. They'll check your lymph nodes in the neck, armpits, and groin area for swelling that might indicate infection or other issues. A neurological assessment tests your reflexes, strength, coordination, and sensory function.

Depending on your age, sex, and risk factors, additional examinations may be appropriate, such as breast exams, testicular exams, or pelvic exams. Discuss with your provider which examinations are recommended for your situation.

Laboratory Tests and Screenings

The specific tests ordered during your annual physical depend on your age, sex, health history, and risk factors. Common tests include a complete blood count to check for anemia and signs of infection, and a comprehensive metabolic panel that evaluates kidney and liver function, electrolyte balance, and blood sugar levels.

Lipid panel testing measures cholesterol levels and cardiovascular risk. Depending on your age and risk factors, you might need thyroid function tests, vitamin D levels, or other specialized blood work. Urinalysis screens for kidney problems, diabetes, and urinary tract infections.

Age-appropriate cancer screenings should be discussed even if they're not performed during the visit itself. This includes mammograms, colonoscopies, Pap smears, PSA testing, and lung cancer screening for those with significant smoking history.

Vaccinations

Your annual physical is an ideal time to review and update your immunizations. Adult vaccinations often include an annual flu shot, Tdap booster every 10 years, shingles vaccine typically starting at age 50, pneumonia vaccines for older adults or those with certain conditions, and COVID-19 vaccines and boosters as recommended. Some adults may also benefit from HPV, hepatitis, or other vaccines depending on risk factors and vaccination history.

Health Counseling and Education

A comprehensive physical should include discussion of preventive health topics relevant to your age and situation. Your provider should offer guidance on nutrition and healthy eating, exercise recommendations, stress management techniques, sleep hygiene, tobacco cessation if applicable, and alcohol use guidelines.

Mental health screening is increasingly recognized as an essential component of preventive care. Your provider may ask about symptoms of depression, anxiety, or other mental health concerns. This is also an opportunity to discuss sexual health, contraception, or fertility planning if relevant to your situation.

How to Prepare for Your Annual Physical

A little preparation can help you get the most value from your annual exam. Before your appointment, make a list of current medications, including prescriptions, over-the-counter drugs, vitamins, and supplements, with dosages. Gather information about your family health history, particularly any new diagnoses in close relatives.

Write down questions or health concerns you want to discuss. It's easy to forget these once you're in the exam room. If you have symptoms you've been meaning to mention, note when they occur, how long they last, and what makes them better or worse.

Consider bringing a list of any specialists you've seen since your last visit and copies of relevant test results if you've had procedures done elsewhere. If you're seeing a new provider, request that your medical records be transferred before your appointment.

For certain tests, you may need to fast for 8-12 hours before your appointment, though this depends on which laboratory tests your provider plans to order. Check ahead of time whether fasting is required. Continue taking your regular medications unless specifically instructed otherwise.

Questions to Ask During Your Visit

Don't hesitate to ask questions during your physical. Consider asking about which screenings you need based on your age and risk factors, whether the results of your vital signs and any tests are within normal ranges, and what lifestyle changes might improve your health markers.

Ask when you should schedule your next visit and what symptoms should prompt you to come in sooner. If you have a family history of certain conditions, ask what preventive measures you can take. Clarify any medications prescribed or discontinued and make sure you understand why.

After Your Appointment

Following your physical, you should receive a summary of your visit, including vital sign measurements, test results, any diagnoses or conditions discussed, and recommended follow-up care. Review this information carefully and keep it in your personal health records.

If laboratory tests were ordered, ask when to expect results and how they'll be communicated. Many healthcare systems now offer patient portals where you can view your results online. Don't assume that no news is good news—proactively check for your results and follow up if you don't receive them within the expected timeframe.

If follow-up appointments were recommended, such as with specialists or for additional testing, schedule these promptly. If lifestyle changes were discussed, create a concrete plan for implementing them. Small, specific goals are more achievable than vague intentions to "eat better" or "exercise more."

When to See Your Provider Between Annual Visits

While annual physicals are important, they don't replace the need to see your provider when health concerns arise. Contact your healthcare team between visits if you experience new or worsening symptoms, have side effects from medications, receive abnormal results from screenings or tests done elsewhere, or have questions about your health that you can't resolve on your own.

Some chronic conditions may require more frequent visits than once per year. Discuss the appropriate follow-up schedule for any ongoing health issues you're managing.

Making the Most of Your Annual Physical

The annual physical exam is a cornerstone of preventive health care. By understanding what should happen during this important visit and preparing thoughtfully, you can ensure you're receiving comprehensive care that's appropriate for your age, sex, and individual health needs.

Remember that you are an active partner in your healthcare. Don't hesitate to speak up if you feel components of the exam were rushed or skipped, or if you have questions that weren't adequately addressed. A thorough annual physical sets the foundation for a year of good health and helps catch potential problems before they become serious.