William J. Higgins, MD, MBA
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Q: Is an annual physical really needed?
A: The annual physical has come under a great deal of scrutiny lately. While its purpose is to identify and help prevent certain conditions, nearly one third of the 177 million Americans who do not keep their annual appointments are unaware they have a chronic disease. At present, some providers do not encourage the annual exam. Some organizations (including the American Medical Association) are now moving toward what is becoming known as the “Periodic Health Assessment.” This would include the use of online risk assessments, questionnaires, and involvement by the chronic care manager who is part of the team in a physician or nurse practitioner’s practice. It should encourage more patients to regularly monitor their health.
Q: What characteristics are assessed during a physical?
A: There are certain patient characteristics that will prompt certain tests during the annual physical. Your weight, height, blood sugar levels, blood pressure, and cholesterol are common items that your doctor may measure during your exam. For example, if a sudden spike in your blood pressure is noted, further tests can be conducted and a treatment plan can be put in place before the condition becomes severe.
Q: How does family history play a role in the annual physical?
A: Family history is certainly important in screening certain patients for colon and breast cancer as well as tests for cholesterol. Routine PAP smears (up to every three years after three consecutive normal results) are also important. Depending on family history, screening colonoscopies may prompt an earlier and more frequent evaluation.
Q: What else will be evaluated?
A: All vital signs should be recorded regularly and discussed. Lifestyle habits will prompt other tests that will be routine such as depression questionnaires and mouth and tongue inspection. Blood screening will help identify risk factors for common chronic diseases. The results of these tests will also be a way for your health care provider to counsel people to promote healthy behavior. Certain blood pressure, cholesterol, and diabetes medications require a fairly routine check of kidney and liver function as well as a “Hemoglobin A1-C” to determine how well diabetes is being controlled overall.
Q: What comes after the physical exam?
A: These measures help to tell each patient his or her own “story.” After an annual physical, a patient should be able to glean insight into their underlying health and risk factors. They should understand how diet and the regular use of daily exercise can positively affect health. Equally as important is an understanding of mental health, a social support network, and how to deal with stress.
The President of the New York Presbyterian Medical Group-Hudson Valley, Dr. Higgins serves as the Vice President of Medical Affairs at NewYork Presbyterian Hudson Valley Hospital. In the Hudson Valley since 1991, he specializes in geriatric medicine and Alzheimer’s disease.. Dr. Higgins has served as director for the Alzheimer’s Association in the Hudson Valley Region. He earned his medical degree from The George Washington University in Washington, D.C. and completed his Internal and Pulmonary Medicine training at Lenox Hill Hospital in New York City. He also holds an MBA from the University of Massachusetts in Amherst, Massachusetts.
NewYork Presbyterian/Hudson Valley Hospital
1980 Crompond Road
Cortlandt Manor, NY 10567