What tests should you ask your primary care doctor to order at your physical?

To answer this question we must first explain the typical annual physical. If your doctor works for a big organization then chances are they get 10-15 minutes to conduct your physical, including the actual exam. I have patients coming in for their physical thinking this is the time to address every medical problem they have or think they might have. Unfortunately you don't want to do that. This appointment is not geared for that. During this visit you are meant to get up to date on your vaccines, screening tests such as mammograms and colonoscopies and blood tests. You might be thinking "shouldn't my doctor already know what to order?" Technically yes they should but does your doctor know what you insurance will pay for? No they do not. Only your insurance can know that since it is constantly changing. But anyhow I digress. A typical doctor working for a big organization is usually always behind. They usually don't have any time for catching up on new medical recommendations. This can be alarming at first but don't worry most electronic medical systems have systems in place reminding your doctor of the basic test to order depending on your age and gender. So the typical basic blood panel that is usually covered for an annual physical is; CBC (complete blood count) which tells us if you are anemic (if your body has less total blood than the average person your age and gender), CMP (complete metabolic panel) which includes basic electrolytes such as potassium and sodium, kidney function and liver function. Lipid panel, which is your different types of cholesterol levels and hgba1c which is a screening test for diabetes. Psa (prostate cancer test) for men over the age of 45-55 depending on which guideline your doctor decides to follow. This is the absolute bare minimum tests we are taught to check in the blood once a patient is over the age of 35 (before this age we are told to just check cholesterol levels). Yes yes I know this does not seem like a sufficient amount of information that your doctor should collect on you. But the most important information comes from you talking to your doctor about how you are feeling overall and your family history. There is a new test that is recommended for primary care doctors to check in all patients over the age of 19. That test is lipoprotein a. Lipoprotein a is an LDL- like particle (what we doctors refer to as bad cholesterol) which is predominantly genetically determined. The level of this particle in your blood gives your doctor an idea of your overall risk of heart disease based on just that particle which your doctor should then combine with the rest of the information they have about you. And remember if you want to talk about your concerns about symptoms or family history or questions that you have make an appointment with your doctor just for that so that you don't take time away from your annual physical which is meant to keep you healthy and prevent problems in the future by ordering the right tests, discussing your diet and exercise, catching up and talking about vaccines, examining you and making sure you get every screening test that is recommended for your age group (that you agree and decide on of course)