Expert Opinion | For older adults, not all annual check-ups are alike
How to make sure you receive the kind of physician's examination that you expect.
A reader recently lamented to me that she went to her doctor’s office for her annual exam and left very frustrated. She was interviewed extensively by a nurse, then asked another battery of questions by her doctor, but was never physically examined.
“What kind of check-up is that?” she said.
It was not the first time I’ve heard frustration over what should be included in an annual check-up.
If you are in the Medicare age group and have recently called your primary care office to schedule an annual visit, you may have been surprised to learn there are different types of annual check-ups which have different health-care goals.
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Many people see their primary-care clinician multiple times throughout the year for a wide range of medical needs: chronic disease management, sickness, review and discussion of test results.
You may want to designate one of these as your annual visit — a time to review your “problem” list, what medications you are taking, as well as recommended health screenings or vaccines, and make plans for future care. These visits may also be important to qualify for insurance discounts. For other people, an annual visit may be the only touch point with a primary-care clinician each year.
It is important to understand the differences to schedule correctly and avoid frustration when you arrive for your appointment:
Annual visits are generally more comprehensive than a sick visit or routine follow up and should be given a longer time slot in the clinician’s schedule. Be clear when requesting an annual visit to help assure that you are given the time you need to talk to your provider and cover a full examination.
A Medicare annual wellness visit, or AWV, is a co-pay free visit type created by the Centers for Medicare and Medicaid Services (CMS) to help encourage older people and their clinicians to address preventive care and other matters that can get missed when responding to an acute medical concern, such as chronic pain assessment, screening for depression and dementia, fall risk, food and housing security, or ability to care for yourself independently. While the AWV covers important medical and social issues, it does not include a physical examination and may be performed by your primary clinician or nurse. It can even be done via Zoom or another virtual platform.
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If you want to be sure to be examined or if you have pressing concerns to address, the AWV may not be the type of medical appointment you need. Some clinicians are willing to address problem issues and perform physical exams at the same time as your AWV, but confirm that in advance. This will help you to set and manage expectations.
Primary care practices are increasingly focusing on wellness and care quality, which is a change for the better. This also means there are more options when you call for a visit, or schedule online. Be sure the visit type that you schedule aligns with your goals for that visit. And don’t be shy about asking for help.
Jeffrey Millstein is an internist and regional medical director for Penn Primary Care.