Things that are covered include the past medical and surgical history, list of all medications, including OTC drugs and herbal supplements, current symptoms, if any, questions the patient has about health-related topics, vaccinations, and screening tests. Information from specialists should be gathered so as to have a complete picture of the care the patient is receiving from all providers. Chronic diseases are discussed and managed during this examination. In the history, the past medical history is covered, including past surgeries and allergies. Lifestyle questions are asked about, such as smoking history, exercise, dietary habits, alcohol and drug use, and safety issues in the home. Medications taken are part of the history as well. The examination is relatively thorough, with a dermatological evaluation, heart and lung exam, abdominal examination, genitourinary examination, and evaluation of muscle strength, gross neurological functioning, and gait. Vital signs are done to check for hypertension and rhythm abnormalities. After the examination, immunizations are given. Immunizations are given to adults as well as children. Labs are done for screening purposes and to follow up for chronic illnesses. Things like mammography, PAP tests, and colonoscopies are done during the annual examination or ordered for a later date. If there are findings on any of the tests, these may need to be discussed with the patient at a later time, particularly if something needs to be done.
PATIENTS PRESENTING FOR ROUTINE SCREENING Routine screening is done at every stage of life. In the young patient above the age of 18 years and up to about 27 years, the patient should have several screening examinations. There is no mammography or colorectal screening in the average-risk patient at this age but cervical cancer screening is done every three years, starting at age 21 and ending at age 65 years. Cytology with HPV testing is done every five years between 30 and 65 years of age. Skin cancer screening is done at the provider’s discretion. Eye examinations are done annually on all diabetic patients but a hearing examination is not done if there are no symptoms. Zika virus screening is done for high-risk female 14
