Five Things to Know About Physicals

Annual checkup, preventative care visit and well-check.

Physical exams go by a variety of names, but the aim and importance of this yearly appointment with your primary care provider (PCP) is the same.  

Erin Anderson, PAC, an advanced practice clinician and primary care provider at South Shore Medical Center, shares five things patients should know about an annual physical.

What an annual physical is and why it’s important

This once-a-year appointment is part of your healthcare for life, from birth through adulthood. And while a physical for a five year old will look rather different from one for a 75 year old, both appointments have the same goals – healthcare maintenance and prevention.

Physicals are an important part of your healthcare and provide an opportunity for you and your PCP to get to know each other and continue a healthy and productive patient-provider relationship. It’s a time to let your doctor know of any important changes to your health history, your family status, any surgeries or new specialists you might be seeing.  The appointment is also a good time for following up on any chronic medical issues to ensure we are managing them appropriately.

What to expect during this checkup

This is an appointment to catch up with your PCP and make sure you have had all your age-appropriate screening tests, including lead and anemia for kids, and mammograms, colonoscopies, and depression screening for adults.  It is also an opportunity to get up to date with any vaccines you might need.

Your physical appointment will start with a medical assistant bringing you into an exam room and checking and recording your vital signs, including blood pressure, pulse, height, weight, and BMI. Depending on your medical history, your O2 saturation, respiratory rate, and a temperature may also be checked. 

Your provider will then talk with you about your recent medical and social history, go over your blood work and your medications as needed, and address any new issues. The physical exam generally involves checking the heart, lungs, abdomen, ears/nose/throat and any areas of concern. Medicare Annual Wellness visits do not include a physical exam, so your provider may skip that part.   

Not everyone needs a physical every year

If you are between the ages of 18 and 40 and do not take any daily medications, you may not need a physical every year. It’s good to see your PCP team at least every other year to remain an active patient with the practice, but for some patients an annual physical isn’t necessary.

You can discuss the appropriate interval of visits with your provider. If you fall within this age group, but prefer to keep a yearly appointment, we can accommodate that as well.

Insurance usually covers the cost of an annual physical

The 2010 Affordable Care Act (ACA) ensures that a yearly physical is fully covered under your insurance plan, which is why you are not charged a copay for these appointments. The goal of the ACA in making physicals available at no cost to patients was to make sure everyone has access to preventive healthcare.

It can get complicated, however, if you have specific issues that you need to discuss with your provider, or if your chronic medical problems require evaluation and management during your physical. These separate problem-focused discussions are not technically covered under preventive health benefits.

Insurance companies require providers to charge separately for non-preventative medical issues, so you may receive a bill for these services after your appointment. For more information about what is covered during a physical exam, visit Healthcare.gov and search “preventive health benefits.”

Why your annual physical could be more than a year away, and how to be seen sooner

When you try to schedule your physical, you may be surprised to find that your PCP is booking well into 2024. Most physicians and advanced practice clinicians (APCs) are fully booked for physical exam appointments many months out.

We advise you take the earliest available appointment for a physical we can offer with your PCP team, and then request to be added to the automated waitlist. If another patient cancels a physical with the same provider, you could be offered an earlier appointment.

Should you require a physical more immediately, for work, sports, or academic purposes, we can usually schedule an appointment, but it may not be with your primary care team.

It’s important to remember that you don’t have to wait for your annual physical to be seen by your PCP. If you need to discuss a medical issue, go over your medications or need to follow up on a chronic condition, you can schedule an office visit within two to four weeks, often sooner. This could be with your PCP or a nurse practitioner (NP) or physician assistant (PA) on their team.  

South Shore Medical Center patients can schedule appointments by phone at 781-878-5200 or by logging into their South Shore MyChart account. Don’t have MyChart? Sign up here.

Erin M. Anderson, PAC is an advanced practice clinician and primary care provider at South Shore Medical Center.