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hronic diseases like heart disease, cancer and diabetes are the cause of death for 70 percent of Americans each year, according the U.S. Centers for Disease Control and Prevention. Yet these same diseases can be largely prevented through screenings and regular checkups.
"Preventive care consists of measures patients can take to prevent disease," explains Ebony Harpool, M.D., of the DMC Family Health Center at Campus Martius. "Your doctor can identify potential health problems before you even feel sick."
Dr. Harpool notes that she often sees patients who have no family history of serious illness or disease and no medical complaints of which to speak. Yet at their annual checkup, she identifies possible health issues either during her examination of the patient or in the patient's blood work. Often these concerns can be addressed before they become serious or require a specialist's care.
"I just saw a patient the other day who said she felt fine," says Dr. Harpool, an internist. "Yet, her annual blood work revealed she was on the border of being pre-diabetic. We caught this before she needed insulin, and instead I was able to start her on an oral medication. A few months or a year later without checking her A1C hemoglobin level, which measures blood sugar over time, and she may have been at the point of needing insulin."
In addition to the health and quality of life benefits preventive care affords is an economic benefit. The CDC indicates that chronic diseases, including heart disease, diabetes and cancer, account for 75 percent of the nation's health spending.
"When disease or illness is caught early, we can try and contain the problem before a lot of additional treatment is needed," Dr. Harpool explains.
That has repercussions for a patient's pocketbook. In general, emergency room visits for non-emergencies mean patients pay more for care.
"By developing a relationship with a primary care physician who a patient sees for routine physicals and blood work, he or she may be able to avoid sometimes costly emergency room visits and procedures," Dr. Harpool notes.
The state's new Healthy Michigan Plan offers low-income individuals and families affordable health care that may make it possible for families to obtain preventive health care services including annual physicals, blood work, vaccinations and important health screenings.
The Healthy Michigan Plan provides qualifying applicants insurance coverage through one of a number of approved insurance carriers at no cost. Minimal co-pays of typically less than $3 may apply for various services. To learn eligibility requirements and application procedures, refer to the article on page 8 or visit Michigan.gov/HealthyMichiganPlan.
Preparing for an annual physical
Ebony Harpool, M.D., of the DMC Family Health Center at Campus Martius, advises patients to prepare for their annual physical by assembling their family medical history, compiling a list of their medications and writing down any questions they may have for the doctor. She encourages patients to bring all of the medications they're currently taking and to alert their physician if there has been any changes to medications, as may happen if the patient is also seeing a specialist for care. She typically schedules patients for blood work at the time of their physical, and patients are required to fast in advance.
"That usually means no food or drink before the appointment," she says. "If a patient forgets and eats something, we may schedule them to come back for the blood work at a different time."
Dr. Harpool says patients can expect to change into a gown during their appointment.
"Typically during a physical, the doctor will conduct a head-to-toe exam," she says.
First steps will include taking the patient's medical history followed or preceded by a check of the patient's weight and blood pressure.
"Then I'll listen to the patient's heart and lungs," she says. "I'll look in their mouth and at their tonsils to make sure there is no sign of infection or inflammation. I'll also check the patient's abdomen to make sure there is no liver or spleen enlargement, and I'll check the pulse in the patient's legs, especially if the patient has a history of coronary artery disease, which can result in peripheral vascular disease."
Other steps Dr. Harpool takes include testing a patient's muscle strength and examining his or her feet.
"People with diabetes tend to lose sensation in their feet," she explains. "If they step on something, they may not even know they have. I also check toenails for fungus."
Female patients can expect a breast exam. Males can expect a prostate exam. Individuals complaining of chest pain or experiencing heart palpitations or high blood pressure may also undergo an electrocardiogram, commonly known as an EKG.
Depending on the patient's age and family medical history, Dr. Harpool may recommend various screenings including those for colon, cervical and breast cancer as well as glaucoma.
"Preventive care also means being sure you're up to date on your immunizations and vaccinations," Dr. Harpool says.
To that end, Dr. Harpool typically recommends her patients receive an annual flu shot if they meet the health criteria to do so.
"If you get the flu and haven't had the flu vaccine, your course may be much worse, especially among smokers, those with chronic obstructive pulmonary disorder (COPD), asthma or diabetes," she says.
"Ultimately, the goal of your annual physical and preventive care measures is to help patients avoid illness and improve their overall health."