Advocating for Yourself in Primary Care: Regular Checkups, Vaccinations, Screenings
Author: Lauren Wheeler, MD, BCPA
Purpose of this guidance: An annual wellness visit (physical examination) should not be a time to stress. Rather, this appointment should help ensure that you are doing the right things and continue to do so for your health and wellbeing. The first step for this is knowledge and being able to communicate with your healthcare provider. Read on to find the right tools for just that!
How Can You Advocate for Yourself at the Doctor?
When you are at the doctor’s office for an urgent problem, it may be straightforward to advocate for yourself. For instance, if you have a spike through your thumb, you’d tell the doctor that your thumb hurts and you’d like them to remove the spike. You are clear about what you want, and if your doctor didn’t live up to your expectations, you’d likely ask more questions or you’d go see a different doctor.
However, most of the time, doctor’s appointments aren’t like that. Medicine is complex–the human body has many intricate systems, each individual has different anatomy and different preferences, and millennia of history in medicine often clashes with constantly changing medical research. The result is that most medical issues don’t have a simple black-and-white solution. This uncertainty is the reason why modern medicine focuses on shared decision making: a process where doctors and patients decide the next steps together, based on the doctor’s medical knowledge and the person’s desires for their life.
One of the best ways to advocate for yourself with your doctor is to ask questions about health and medicine. Think of these professionals a bit like your personal medical experts—they should be able to explain their medical knowledge in a way you understand to help you make decisions for your life. It is important that you understand your health conditions, medications, and any proposed tests or treatments. It can help to make a list of questions ahead of time.
What Should Happen at a Regular Doctor Checkup?
Actually, whether or not we should even have routine wellness visits (as they are called by Medicare) is one of medicine’s gray areas. Some experts think checkups are more of a left-over from a time when doctors claimed they always knew best. After all, if something was wrong, you’d know about it and go to the doctor yourself, right?
Research has shown there is some truth to this. When people don’t get regular checkups, they live about as long as people who do. However, general medical visits can help people live better lives, with fewer chronic illnesses and more positive feelings about their health. Many consider wellness visits a necessary preventative health measure.
In order to help people live healthier lives, routine health checks often focus on a few key areas:
Lifestyle discussion: Although this may not be the most fun part of visiting the doctor, they can help remind you to pay attention to your diet, exercise, and substance use habits.
Screening for health and disease (more below)
Updating vaccinations (more below)
Building a healthy patient-provider relationship. This benefit is less obvious, but when you get sick, your doctor will already know many things about you, like how you normally look and feel, what medications you take, your family history, and more. Plus, you’ll already know a doctor you can trust.
Note that this isn’t always a physical exam—unless there’s a specific reason to examine you, like if you are a teen starting school sports.
What is a Biometric Health Screening?
A health screening is a way to quickly collect some numbers (or other information) that give a snapshot of your health status. Biometric health screenings offered by communities, employers, or insurance companies often focus on data that can predict general risk of disease like cholesterol, blood pressure, and weight. Many companies offer financial incentives to those employees who complete these activities (like extra money to the employee’s health savings account).
Combined with information about your lifestyle (things like smoking, sexual activity, sun exposure, etc.), a provider can help you calculate your risk of different health events and come up with ways to reduce these risks. For example, they may recommend having a Pap smear test to decrease your risk for cervical cancer complications. Generally, doctors follow the guidelines set by medical societies (like ACOG for obstetricians) or the US Preventive Services Task Force (USPSTF).
If you want to be proactive, you can use look at the USPSTF recommendations for a person of your age and sex/gender. (A simplified version here.) You and your doctor should decide together which recommendations make sense for you. One consideration is that many preventative screenings, especially if they are invasive or the benefits are uncertain, do cause harm, at least for some people. While all of these guidelines rely on data from large population studies and evaluate the risks and benefits of each action before making a recommendation, you decide which ones you want to do.
Be sure you get the results of any tests done and find out what they mean. Also, ask about costs upfront –most preventative health measures are required to be covered by insurance.
What about recommended immunizations and vaccines?
Vaccination has been somewhat controversial for hundreds of years. The idea of injecting something that seems scary into a healthy adult or child inspires a little caution, no matter how safe vaccines actually are. In fact, some vaccines are not safe for some people with very weak immune systems. However, this is another great opportunity to talk to your (or your child’s) doctor about the individual risks and benefits.
If you want to be sure that you are staying up-to-date with all of your vaccines, the CDC has a tool for adults that helps you look at which vaccines might be recommended for your age and lifestyle (like if you are exposed to body fluids at work or not). There is also one for children.
In conclusion, advocating for yourself during a check-up can be as simple as asking for more information about your diabetes or other chronic illness, or it can look like asking your personal health professional to help you decide if a new screening test or vaccine is right for you. Scheduling appointments for preventative care (when you aren’t sick) and speaking up about what you care about are great ways to practice your self-advocacy skills and build a healthy partnership with your provider!
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License (CC-BY-ND-4.0), available at https://creativecommons.org/licenses/by-nd/4.0/
Signed-off-by: Lauren Wheeler