In anticipation of my physical, and partly to assuage fears that the post-big four-oh one would entail uncomfortable things, I sleuthed around for things on what to expect, thinking. Clearly I’ve been watching too many episodes of House.
The American Academy of Family Physicians1 has six classifications for their recommendations of common “clinical preventive services:”
SR – Strongly recommended: there’s a net gain, it’s cost effective. Vaccines top the list: MMR[4] (despite the anti-vaccination lunacy), tetanus booster, and diptheria/pertussis. Blood pressure is always/easily checked. Since I’m over 35, they want to check lipids (cholesterol and triglycerides). Anticipating this, I fasted prior to the appointment. It’s logistically unfortunate they don’t do the tests and process the results before the doctor visit, because I would like the option of asking what the numbers mean. R – Recommended: moderate benefit or moderate evidence. There were a lot of these. Rather than sifting through the conditionals (e.g., “for women over 65 years of age”), it was easier to consult the male[2]- or female[2]-specific charts. NR – No recommendation: there are only four of these in the 15 page list. The only one I’d heard of was screening for chlamydia in pregnant women over 26 years old. RA – Recommended against. I wasn’t entirely surprised they recommend against taking beta-carotene supplements. However, one that did turn my head was the recommendation against routine screening for testicular cancer[6], especially with the Lance Armstrong awareness campaigns[5]. I – Insufficient evidence to make a recommendation either way. This was one area I was surprised: prostate[7] and skin cancer[8] screening fall into this category. HB – Healthy behavior that’s desirable, but a physician’s advice and counseling might not effective. For example, physical activity is recognized as beneficial. Like the physical I had a few years go, this was easy:
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