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A Closer Look

by Daniel Sean Kaye
Why everyone should be up to date on their physicals and health exams

An ounce of prevention is worth a pound of cure. An apple a day keeps the doctor away. Better safe than sorry. These famous sayings have a ring of truth, don’t they? When it comes to health care, everyone needs checkups—no matter your age, gender or exercise regimen. But what makes an effective exam? Area experts share with us the guidelines they encourage.

Your Physical
“A ‘physical’ has many names—‘annual check-up,’ ‘routine exam,’ ‘well visit,’ ‘comprehensive physical exam.’ [I pick] ‘well exam’ because the focus of this visit should be prevention,” says Monica Atkinson, MD, board certified by American Board of Family Medicine and medical director of Reliance West, the Camden County branch of Reliance Medical Group, a privately owned multispecialty company with more than 25 offices in Atlantic and Camden counties.

“A well visit concentrates on primary prevention, which consists of ‘catching’ the disease before it happens,” explains Atkinson. They include recommended screenings and the opportunity for patients to ask health-related questions. “The media [bombards us] with tons of information about what we should eat and avoid eating, how often we should exercise, and what supplements we should take. The doctor is a good, reliable source of information and can help give personalized advice,” she says.

“A complete exam from head to toe includes neurological and psychiatric evaluation; a review of past medical and social history and of medications in use, and blood tests as needed, as preventive measures depend on the age of the patients,” adds S. Jay Mirmanesh, MD, MBA, of Advocare Pediatric and Adult Medicine in Marlton and Sicklerville.

Mirmanesh echoes the importance of prevention information. “We concentrate on prevention measures during well exams,” he says. Exams are important for the preventive measures they offer “to detect early signs of chronic diseases,” he says.

The visit is also a good opportunity “for the physician to identify risk factors that might have occurred since the last visit,” says Atkinson. These include an increase in waist line and BMI (body mass index), elevated blood pressure or blood sugar, and so forth. “It takes about 30 seconds for a good doctor to pick up on ‘red flags’ like abnormal vital signs, sick appearance of the patient, etc.,” she says.

And well visits go beyond the annual checkup with your family doctor.

Women’s Needs
Michelle Iavicoli, M.D., of Cooper Faculty Group, focuses on menopause medicine, alternative treatment options to hysterectomy, high-risk obstetrics and adolescent medicine. “A proper gynecologic exam includes a thorough patient and family history, a complete [physical] exam, and time to discuss contraception, STD, screening studies, etc.,” says Iavicoli.

While a patient may not need a pap yearly, there are other parts of the exam that are necessary on a yearly basis, such as a breast exam and more. “Annual gynecological exams are important because we can often detect abnormalities before they become evident to the patients ... a subtle change in the breast, an enlarged ovary, an early infection of the cervix,” she says. “Early breast disease, ovarian cysts, pre-cancer of the cervix, and some STDs aren’t easily detected by the patient. But, they could be detected on a gynecological exam at an early treatable stage.”

Iavicoli has found serious medical issues during exams, including a breast mass, a pelvic mass, an enlarged ovary and uterus, a cervical polyp, a cervical infection, a vulvar lesion, and cancers of all types—breast, cervix, uterine, and others.

Dental Issues
Dr. Jeffrey L. Schupper and Dr. Poonam P. Mashru are dentists with Family Dental Care of South Jersey in Voorhees. Schupper says a proper dental examination will observe all soft and hard tissues and associated structures of the head and neck, and will include any necessary X-rays. “In adult patients, we focus more on the periodontium (gums) than in a younger person. We’re also more concerned with oral cancers in adults rather than kids,” he says. “In kids, we’re concerned with the eruption pattern of the adult teeth and the alignment of those teeth. Also, kids who do not have fluoridated water at home may be more susceptible to cavities and decay.”

Mashru, a credentialed preferred provider with Invisalign (tooth movement with aligners or trays, not braces), says everyone, regardless of age, should get a dental exam every six months, starting at 1 year old. “Each patient will get a full examination of the oral cavity pertaining to the health of their gums. Children are checked for … ways to help implement good oral health habits at home,” she says.

“Periodic exams and checkups are essential to practicing preventive dentistry,” says Mashru. “They help keep the patient healthy, and also keep the cost down for the patient by catching things early.” It’s better to treat a small problem versus one that causes pain and is extensive and expensive, she says.

There are many dental issues that don’t have symptoms like pain or swelling, says Schupper, and checkups can reveal them. “People are often surprised at their dental examination. Most often, cavities do not hurt until they get deep, so patients are often surprised that they have cavities,” Schupper says. “Periodontal disease, which affects up to 85 percent of the adult population, is a symptomless disease. It’s also important to catch things early. A cavity caught early needs just a filling, but if left long enough, it may need a root canal.” Oral cancers are often painless in the beginning stages as well, he adds.

A good exam shows the patient what they need to do to stay healthy. “Most people are not aware of how their diet and medication affects their oral health,” says Mashru. “[At their exam,] a patient can learn better habits for their homecare, ensuring a lifetime of healthy teeth,” she says.

Resources

Advocare Pediatric and Adult Medicine
12000 Lincoln Drive W., Marlton
800 Liberty Place, Sicklerville
AdvocareDocMir.com

Cooper Faculty Group, Cooper University Hospital
1103 N. Kings Highway, Suite 201
Cherry Hill
(856) 321-1800
CooperHealth.org

Family Dental Care of South Jersey
707 Haddonfield Berlin Road, Unit B
Voorhees
(856) 309-2244
FamilyDentalCareOfSouthJersey.com

Reliance Medical Group
1401 Route 70 E., Suite 1
Cherry Hill
(856) 429-7600
RelianceMed.com

Published (and copyrighted) in the Art of Living Well pull-out section of Suburban Family Magazine, Volume 3, Issue 7 (September, 2012).
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