What happens at the annual physical?
As the summer proceeds, families are still busy traveling and having fun. School time will roll around much sooner than we think. Come August, everyone will realize it’s back to school time and kids have not had their physical exams yet. All of a sudden, it becomes an emergency. I can’t tell you how many parents call crying and begging because otherwise their children can’t participate in sports. Some parents don’t think annual physicals are important because their children are not sick. The same way that we take our cars for regular servicing, we should take our children and ourselves for preventive care. It’s sad, we sometimes take better care of our cars than our kids.
What happens at the annual physical? This week, we’ll focus on teens and net week on younger kids.
1. Growth monitoring
The basic part of this is to check your teen’s height, weight and development to make sure everything is proceeding as it should. This is when we determine whether your child’s weight is appropriate for height or if your teen is overweight or even obese. Some parents get upset when weight is discussed and I can understand the desire to protect one’s child from any unpleasantness but isn’t it better for us to detect a problem early and work on it? This is important because it’s not just about criticizing your teen’s weight, it is about giving you tools and ideas about how to tackle this problem together as a family.
2. Sex Education
One of the other things we discuss at the health maintenance visit is your teen’s sexuality. Your doctor or midlevel provider may ask you to step out of the room when it comes to this part of the exam and this is not because we don’t trust you or we want to collude with your teens but some teens feel more comfortable talking to the healthcare provider alone. Teens often give us information they would never talk to their parents about and we are able to give them appropriate advice for prevention of sexually transmitted diseases and pregnancy prevention. The first option we all want is abstinence but I’m sure most parents will agree, the second best option is being sexually responsible. After talking to quite a few teen moms, the message which comes across is “no one advised us or gave us any sex education.” It is vitally important that your provider talks to your teens and encourages your teens to be honest and talk to you about the reality of their lives. We also sometimes screen teens for sexually transmitted diseases because as you can imagine teens are not always as truthful as they should be and it’s better to find out and treat your child, rather than pretend this is not an issue.
3. Accident prevention
The other very important topic we discuss is accident prevention. This is especially important as our teens start driving. We emphasize to them the use of seatbelts and the importance of never drinking and driving. We discuss the use of appropriate gear for accident prevention during sports, like mouth guards, and helmets. We discuss teens not using drugs, smoking and alcohol. We talk to them about gang violence and gun violence and give you tools on how to recognize the changes that happen if your teens unfortunately get involved in drugs.
4. Chronic Illnesses
As the parent of any athlete knows, there is a physical form that has to be filled out by your primary care provider before your teen can participate in sports. One of the important questions on there is about family history. There are certain medical conditions which run in families and can significantly impact your teen if they choose to do sports. The physical exam discusses these conditions and determines whether your child needs to see a specialist prior to being cleared for sports. We also screen for illnesses like Diabetes and high cholesterol and discuss management before symptoms worsen. You’ll be amazed at some of the illnesses picked up during the routine health maintenance exam, like scrotal masses, scoliosis, breast abnormalities etc, conditions you may not realize your teens have because they want their privacy and don’t allow you to see them. One of my friends actually realized a teen was not only pregnant but due for delivery and mom had not even noticed this.
5. Mental issues
Another very important screening we do for our teens is screening for depression and other psychologic problems they may have, which you may not even be aware of. We then give the whole family resources to help them navigate the way forward if any mental disorders are identified. It is also imperative for us to recognize if your teen has anger management issues or if he or she is bullying others so we can deal with the problem before it escalates.
The annual health maintenance exam for teens is a vital part of their healthcare and is paid for by most insurances. This is when you, the parent, get the opportunity to talk to your teens’ healthcare provider about any concerns you may have. Your healthcare provider in addition to directly talking to your teen about issues like sex education, appropriate development, and accident prevention, also provides you tools on how to discuss these topics with your teens. We screen for chronic or life threatening illnesses and make sure your teen is physically, mentally and emotionally ready to tackle the new school year and participate in sports successfully. Take this responsibility seriously and prepare your teens for success.