For many years, you couldn\u2019t use your health insurance for a check-up. The attitude of health insurance companies was essentially that they were available when you got sick, period. But if you were just fine? \u201cDon\u2019t call us.\u201d<\/p>\n\n\n\n
To make their point especially clear, if you did visit your doctor for a check-up and she diagnosed you as \u201chealthy female\u201d and coded the insurance claim as \u201cwell person examination,\u201d your claim would be denied and on the bill you\u2019d read the now-familiar phrase \u201cnot a covered benefit.\u201d To fight back against this tidbit of corporate greed, doctors would routinely submit check-up claims with innocuous diagnoses the patient might have had in the past, like \u201cmenstrual cramps\u201d or \u201csore throat,\u201d so you wouldn\u2019t get stuck with the bill.<\/p>\n\n\n\n
In recent years, this has changed\u2026a little. The insurance companies discovered that prevention pays off in the long run and today a reasonable health insurance policy usually includes a so-called wellness exam you\u2019re entitled to annually. They\u2019re quite strict about the once yearly stance\u2014arrive a month early and you\u2019ll pay for the thing yourself.<\/p>\n\n\n\n
While this is an improvement, it\u2019s a pretty lame one. Everything considered, you don\u2019t get much in a wellness exam. It starts to look like just another buzzword, like \u201cHMO\u201d (health maintenance organization) having absolutely nothing to do with maintaining health.<\/p>\n\n\n\n
After you\u2019ve updated your health history questionnaire, you\u2019re given a physical exam of variable quality by an MD, DO (doctor of osteopathy), physician assistant, or certified nurse practitioner. The examiner reads through your questionnaire, asks a couple questions, and then asks if you have any problems that need to be addressed. If you say \u201cNo, I\u2019m fine really,\u201d you\u2019ll be directed to the lab where a technician will draw blood for a blood count, a metabolic profile (which checks for diabetes, liver and kidney disease, and electrolytes), and a cholesterol test. You\u2019ll leave some urine and you\u2019re out the door. If you pull out a list of problems, you\u2019re usually rescheduled for follow-up visits.<\/p>\n\n\n\n
Most patients report they never hear anything until their next wellness exam a year later (\u201cI guess no news is good news\u201d) and rarely get copies of test results. In surveys during which wellness exams were timed, most busy offices finished up in less than 15 minutes. Since two thirds of us are overweight, there\u2019s a good chance the only piece of advice you\u2019ll hear is \u201cBetter keep an eye on that weight,\u201d which of course you knew before you made the appointment. But you\u2019ve got the satisfaction of thinking, \u201cWell, I seem to have passed my wellness exam. I must be reasonably healthy.\u201d<\/p>\n\n\n\n
Not to spoil your day, but you\u2019ve also heard of people falling over dead weeks after a perfect exam. Or instead, and far more commonly, as the years unspool and you continue to get annual exams, you find yourself slowly but steadily deteriorating. Your weight and blood pressure inch upward, your pre-diabetes becomes diabetes, or your occasional low back pain gets worse. You find yourself taking one prescription drug, another, and maybe a third, all the while faithfully getting your annual exam.<\/p>\n\n\n\n
\u201cWhat happened to me?\u201d you might wonder, \u201cI was getting my wellness exams and everything seemed fine.\u201d This isn\u2019t unusual. Frankly, annual exams provide a false sense of confidence. The various tests didn\u2019t find any specific disease, so you assumed you were doing everything right. But normal test results obtained during a single doctor visit are far from a guarantee of long-term good health. There\u2019s much more to it.<\/p>\n\n\n\n
So here\u2019s my suggestion for staying well while significantly increasing your odds for life-long health. First, rethink your role as a health care consumer, from one of passive recipient of an annual exam to proactive organizer of your own life. Rather than placing your health in the hands of a busy doctor who sees you a few minutes a year, create your own team of health care practitioners, with you as the captain. Your team might include:<\/p>\n\n\n\n
A family practitioner or nurse practitioner <\/strong>You really should have someone to call if you get sick, a name to hand the registration clerk if you land in an emergency room, and someone to renew your birth control pills, fill out various forms, and coordinate care among specialists should the need arise. If you\u2019re under 60, consider yourself healthy, and your tests have been normal, you don\u2019t need an annual wellness exam. Every three to four years is fine. I don\u2019t believe healthy women need to see an ob-gyn. Most family practitioners and nurse practitioners do breast exams and Pap smears, but this is your choice. Midwives are a good choice for Pap smears, too.<\/p>\n\n\n\n A chiropractic physician<\/strong> should be on everyone\u2019s team. The musculoskeletal system is often the first to cause problems (injuries, wear and tear) and your chiropractor can perform a thorough check on all this (completely different from your family practitioner, by the way) and point out areas that may need preventive or rehabilitative exercises. An ancillary practitioner here would be a massage therapist<\/strong>. The long-term benefits of regular massage (monthly, for example) to overall health are well known. And you\u2019ll certainly feel emotionally and physically much better after a massage than you would after visiting your internist or gastroenterologist.<\/p>\n\n\n\n Since so many chronic illnesses are related to what we eat, just about everyone can benefit from a couple sessions with a clinical nutritionist<\/strong>, who can review your eating habits, suggest improvements, and show you how to shop for food. Well-meaning vegetarians often have vitamin deficiencies and lots of people think a half dozen diet soft drinks every day are a helpful way to control their weight. If anyone on your team has the potential to add a decade to your lifespan, it\u2019s a nutritionist.<\/p>\n\n\n\n