Benjamin Franklin said it in 1736. Nearly three centuries later, we still struggle to incorporate this axiom into our lives — in particular, when it comes to healthcare.
The annual exam. Cancer screenings. Immunizations. These small to-dos can make a big difference when it comes to catching (and preventing) chronic disease and illness — or even just bad habits — early on, when they are most treatable.
Dr. Samantha Ober, who practices internal medicine at GBMC Health Partners Primary Care – Hunt Valley, is passionate about preventive care. A relative newcomer to the practice, Ober spends about half her time in the office doing annual physicals — either getting to know new patients or guiding her older population of patients through Medicare wellness exams. “Preventing illness is a priority,” she says.
MIND THE SCHEDULEHealthy adults don’t need much in terms of cancer screenings. Here are a few to keep in mind.
CERVICAL CANCER SCREENING (I.E. PAP SMEARS). “Regular pap smears —every three to five years — begin around age 21 and usually finish around age 65, as long as a woman’s last three paps are normal,” says Ober.
BREAST CANCER SCREENING (I.E. MAMMOGRAMS). “There are different recommendations, but we start the conversation at age 40,” says Ober. Mammograms are typically every one to two years.
COLON CANCER SCREENING (I.E. COLONOSCOPY). This is for men and women starting at age 50 — or earlier if there is a family history. If your colonoscopy is clear, you can wait another 10 years before getting another.
PROSTATE CANCER SCREENING (E.G. PSA TEST). Ober is sure to talk to her male patients about the risks and benefits of the PSA blood test, which is somewhat controversial. She says, “We do what we call ‘shared decision making’ with each patient.”
LUNG CANCER SCREENING. “This is indicated for a very select population that meets a number of criteria,” says Ober.
In addition to cancer screenings, annual exams are the ideal time to stay on top of conditions like osteoporosis, as well as the recommended vaccine schedule for adults. That includes:
AN ANNUAL FLU SHOT. “We ask all of our patients if they’ve gotten a flu shot and it’s exciting when someone says yes,” says Ober. There are so many misconceptions about the flu shot, Ober finds herself doing a lot of patient education. “This flu season, we’ve already seen a number of flu-positive people — young, healthy people, 20- and 30-somethings — who are completely knocked out because they didn't get their flu shot.”
TETANUS SHOT. Adults need a tetanus booster every 10 years.
PNEUMONIA SHOTS. “Once you get to a later stage in life, something like a pneumonia can really take someone out,” says Ober. Vaccine schedules may vary between patients based on their given medical conditions, but everyone should receive a pneumonia shot at age 65.
SHINGLES SHOT. Anyone who's had chicken pox is at risk for shingles as an adult. “I really do stress getting a shingles shot,” says Ober. The latest shingles vaccine is given at age 50 and is made up of two doses, given two to six months apart.
SEEING THE WHOLE PATIENTThe annual visit can feel like an additional to-do item for otherwise healthy adults. For those managing chronic conditions, it means yet another appointment. But it is so much more than that.
Beyond the checklist of shots and screenings, the annual exam is a time to connect that isn’t about a chronic condition or crisis. For Ober, it’s an opportunity to talk about diet and lifestyle, mental health, substance use, physical activity or, for an older population, about memory issues or fall risks. Says Ober, “It’s all the stuff we don't talk about if they’re coming in for a cold or UTI or back pain.”
Ober’s goal is always to see the whole patient at every visit, but one 30-minute appointment can fly by when a patient is, for instance, managing diabetes. “When I need to look at their blood sugar and adjust their insulin, it’s hard to pause to say, How is your mood today? How are you doing?” But that one extra visit every year gives both doctor and patient an opportunity to do just that — to start a conversation that may very result in a longer, healthier life.