Who should have a well-check visit?

Well-checks should begin at birth. This is when infants receive their vaccinations and their weight is monitored. Well-checks should continue during the pediatric and teen years and throughout a person’s lifetime. Annual well-checks can help find problems early, when your chances for treatment and cure are better.

The U.S. Department of Health and Human Services reminds parents that regular checkups are an opportunity to check a child's development.

Other than checkups, school-age children should be seen for:

• Significant weight gain or loss
• Sleep problems or change in behavior
• Fever higher than 102
• Rashes or skin infections
• Frequent sore throats
• Breathing problems

Routine physicals give physicians the chance to do more preventive care practices, including screenings, vaccines and other health maintenance. During an annual physical, physicians also have the chance to connect and develop relationships with their patients and, in turn, patients can voice concerns and ask their primary care physician specific questions to help them gain a better understanding of their health care, which improves their overall health literacy (a person’s ability to read, understand and use healthcare information to make decisions and follow instructions for treatment) in the process.

As you age, it may feel like you go to more doctor appointments. But whether it's for routine checkups or managing a chronic health problem, don’t skip those visits. Maintaining your health can mean keeping your independence. There continues to be new methods to screen for, treat, and lower your risk of diseases such as heart disease, stroke, and cancer. Take charge of your health by getting all the recommended regular screenings.

• Infant and Toddler Years
• Adolescent Years
• Teenage Years
• Early Adulthood
• Middle Adulthood
• Late Adulthood

Infant and Toddler Years

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 and information for parents. Special attention is paid to whether the infant has met the normal developmental milestones.

Here are some things your doctor may ask you about your baby:

• What kinds of solid food is your child eating? How's his appetite? Does he enjoy feeding himself finger foods?
• How many teeth has your child cut?
• Is your child crawling well? Pulling up? Cruising or walking? Pointing? Making eye contact and responding to his name?
• Vision - Have you noticed frequent squinting or eye rubbing, or a tendency to hold toys and books close to his face?
• Hearing - Does your child turn toward sounds?
• Speech - Does your child imitate sounds, babble, or say any words?

You doctor will also check for or discuss:

• Gross Motor Skills (use of large muscles in the legs and arms)
  • Stands alone well by 12 months
  • Walks well by 12 - 15 months (if the child is not walking by 18 months, he or she should be evaluated by a health care provider)
  • Learns to walk backwards and up steps with help at about 16 - 18 months
  • Throws a ball overhand and kicks a ball forward at about 18 - 24 months
  • Jumps in place by about 24 months
  • Rides a tricycle and stands briefly on one foot by about 36 months
   
• Fine Motor Skills (use of small muscles in hands and fingers)
  • Makes tower of three cubes by around 15 months
  • Scribbles by 15 - 18 months
  • Can use spoon and drink from a cup by 24 months
  • Can copy a circle by 36 months
   
• Language Development
  • Uses two - three words (other than Mama or Dada) at 12 - 15 months
  • Understands and follows simple commands ("bring to Mommy") at 14 - 16 months
  • Names pictures of items and animals at 18 - 24 months
  • Points to named body parts at 18 - 24 months
  • Begins to say his or her own name at 22 - 24 months
  • Combines two words at 16 to 24 months -- there is a range of ages at which children are first able to combine words into sentences; if a toddler cannot do so by 24 months, parents should consult their health care provider
  • Knows gender and age by 36 months
   

Adolescent Years

Even if your child is healthy, continue bringing him/her to the doctor for yearly checkups. This ensures your child’s health is protected with scheduled vaccinations. And the doctor can make sure your child’s growth and development is progressing well.

Your doctor will look at your child’s development in speech, behavior, and motor skills. It is also a good time to make sure your child is up to date on vaccinations.

Teenage Years

Your medical history is your chance to mention any complaints or concerns about your health. Your doctor will also likely quiz you about important behaviors, like smoking, excessive alcohol use, sexual health, diet and exercise. The doctor will also check on your vaccination status and update your personal and family medical history.

• Vital Signs
  • Blood pressure: less than 120 over 80 is a normal blood pressure.
  • Heart rate: Values between 60 and 100 are considered normal.
  • Respiration rate: Around 16 is normal.
   
• Temperature
• General Appearance. Your doctor gathers a large amount of information about you and your health just by watching and talking to you.
• Heart Exam
• Lung Exam
• Head and Neck Exam
• Abdominal Exam
• Neurological Exam
• Dermatological Exam
• Extremities Exam

Teens should also be checked for scoliosis (curvature of the spine). Medical care for teens should include screenings for high blood pressure, obesity and eating disorders. A tuberculin (PPD) test may be done if a teen is at risk for tuberculosis.

Early Adulthood

• Have a yearly physical exam.
• Starting at age 18, have your blood pressure checked at least every two years.
• Get screened for diabetes if your blood pressure is high or if you take medication for blood pressure.
• Have a screening for chlamydia if you are 24 or younger and sexually active
• Make sure your childhood vaccines are up to date and that you’ve received appropriate boosters.
• Get the HPV vaccine before becoming sexually active.
• Starting at age 20, have your cholesterol checked regularly if you:
  • Use tobacco
  • Are obese
  • Have diabetes or high blood pressure
  • Have a personal history of heart disease or blocked arteries
   
• Have your body mass index checked

Middle Adulthood

• Have a yearly physical exam.
• Have your blood pressure checked every two years unless it is 120-139/80-89 Hg or higher. Then have it checked more frequently as recommended by your physician.
  • If the top number (systolic number) is greater than 130 or the bottom number (diastolic number) is greater than 85, call your doctor.
  • If your blood pressure is above 135/80, your health care provider will test your blood sugar levels for diabetes.
  • If you have diabetes, heart disease, kidney problems, or certain other conditions, you may need to be monitored more closely.
   
• Men and women over age 44 should have cholesterol screening every five years or more frequently according to your risk factors.
• People between the ages of 50 and 75 should be screened for colorectal cancer.
  • Colonoscopy every ten years or an alternative study for examination of the colon as recommended by your physician.
  • People with risk factors for colon cancer such as ulcerative colitis, a personal or family history of colorectal cancer, or a history of large colorectal adenomas may need a colonoscopy more often.
   
• Go to the dentist twice a year for an exam and cleaning.
• Have an eye exam every two years including testing for glaucoma after age 45.
• You should receive a flu vaccine every year.
• Ask your doctor if you should get a vaccine to reduce your risk of pneumonia.
• Adults aged 50 and over should get the shingles vaccine.
• You should have a combined tetanus, diphtheria and pertussis (Tdap) vaccine as part of your initial vaccinations. Additionally, you should have a Tdap booster every ten years.
• Your height, weight, and body mass index (BMI) should be checked at each exam.
• Women should do a monthly breast self-exam.
• A health care provider should do a complete breast exam every year.
• Women over age 40 should have a mammogram done every one to two years, depending on their risk factors.
• Post-menopausal women should have a screening test for osteoporosis, also known as a DEXA scan.
• Ask your doctor about the proper calcium intake and exercise needed to help prevent osteoporosis.
• Women should have Pap smears annually to screen for uterine and cervical cancer.
  • If your Pap smears have been normal three times in a row, your doctor may tell you that you only need a Pap smear once every three years.
   
• Women who are sexually active should be screened for chlamydia infection. This can be done during a pelvic exam.

Later Adulthood

• Have a yearly physical exam.
• Have your blood pressure checked every year.
• If your cholesterol level is normal, have it rechecked every three to five years or as recommended by your physician.
• If you have diabetes, heart disease, kidney problems, or certain other conditions, you may need to be monitored more closely.
• Colon cancer screening should be continued for older aged patients at the recommendation of your doctor.
• Go to the dentist twice a year for an exam and cleaning.
• If your blood pressure is above 135/80, your health care provider will test your blood sugar levels for diabetes.
• Have an eye exam every two years including glaucoma screenings.
• Have your hearing tested every year or if you notice changes.
• If you are over age 65, get a pneumococcal vaccine if you have never had before, or if you received one more than five years before you turned 65.
• Get a flu shot every year.
• Get a tetanus-diphtheria-pertussis booster every ten years.
• Get the Shingles vaccine if you haven’t already been vaccinated.
• With each exam, you should have your height, weight, and body mass index (BMI) checked.
• Women may do a monthly breast self-exam.
  • A health care provider should do a complete breast exam every year.
  • Women should have a mammogram done every one to two years, depending on their risk factors
   
• All women should have a bone density test (DEXA scan) to screen for osteoporosis.
  • Ask your doctor about the proper calcium intake and exercise needed to help prevent osteoporosis.
   
• After age 65, most women may stop having Pap smears as long as they have had three negative tests within the past ten years.

At your annual well-check visit, discuss any health concerns that you may have, and your physician will work with you on a personal care plan.

Now, more than ever, patients have the opportunity to play a more active role in their health care.

• Learn more about various annual well checks.
• Learn more about physical examinations.
• Learn more about annual physicals.