Communication is Key to an Effective Physical Exam

Physical exams are intended to identify problems before they impact a person's health and are a chance for patients to discuss any nagging physical concerns. To benefit most from a physical, patients must communicate with the examining doctor and may need to make a follow-up call to the medical office for results, Cooper Wellness experts say.

Cooper Wellness offers healthy stay-overs of two and six days, focused on exercise and nutrition, at its Dallas lodgings and facilities. A visit can begin with a comprehensive, physical exam at the famed Cooper Clinic, where a doctor spends up to an hour with a patient. A Cooper Clinic physical is encouraged and is offered at an extra charge during a Cooper Wellness stay-over. 

In-depth, Cooper Clinic physicals look for much more than regular physicals do, and employ a treadmill stress test to assess heart health. Dr. Kenneth Cooper, founder of The Cooper Institute and known as the father of aerobics, says “the heart is masterful at disguising its problems.” In a stress test, the patient is hooked to monitoring equipment while exercising on a treadmill. Stress-testing assesses heart health, overall fitness, and how the nervous system responds to stress with adjustments in heart rate and rhythm.

Todd Whitthorne, executive director at Cooper Wellness, says “since heart disease often goes undiagnosed, our clinic uses the treadmill stress test as the foundation of the cardio evaluation in its physical exam.”

Outside of the Cooper Clinic, physical exams follow a fairly standard format “Physicals are usually customized for age, gender, medical history and specific needs,” says Riva Rahl, Cooper Wellness medical director. Exams are recommended every one to five years, and for those over age 50, every one to two years, she says. During a typical physical in any medical office, weight, height and body mass index or BMI are recorded. “Pulse is felt to check heart rate, rhythm and regularity and to flag any circulation problems,” Rahl says. Each pulse matches a heartbeat that pumps blood into the arteries. The pulse's force indicates the strength of blood flowing to various regions of the body.

A stethoscope is used in the exam to listen closely to heartbeats. The examining doctor listens for heart rhythms and evaluates heart and valve functioning. Rahl says “abnormalities that might be detected include murmurs or sounds made by blood flowing through the heart, which can indicate a leaky heart valve. The physician might hear a clicking sound made by a valve that is stiff or narrowed.”

Blood pressure is taken in a typical exam. The physician checks for any swelling, which can be a sign of improper heart pumping, Rahl says. The doctor looks at the ears, nose, throat and eyes and examines the neck for the size of the thyroid gland and enlarged lymph nodes. Skin is examined for color, and if color is good the body is usually getting an adequate supply of oxygen-rich blood, she says. The physician will also feel the skin for warmth.

In the exam, the abdomen, arms, and legs will be checked, and for women a breast exam is often conducted. A urinalysis, blood test and a pap smear will likely be done. A neurological exam often occurs at the same time as a physical--especially in the case of spine problems.

Men and women ages 50 and older should discuss risk factors for osteoporosis with the examining physician, Rahl advises. Men age 50 or older should ask about screening for prostate cancer. “If you have any health concerns or pains, tell the doctor,” she says. “During an exam, the physician relies on the patient for feedback. The patient should answer questions fully, giving details whenever possible.”

“For example, you may feel pain when the doctor asks you to crook your knee or elbow, so explain how much it hurts,” Rahl says. “The doctor can detect pain from a groan or face grimace but you must describe the intensity, location and duration of your pain.” Information from the patient is a window to what’s happening inside the body, and is as good a guide, if not better, than tests.

The Cooper Clinic has more than a dozen physicians on staff conducting comprehensive, physical exams. To uncover problems, the clinic's exams offer many tests that aren't provided in a typical physical. After your exam, ask questions and request that the physician and medical assistants speak in words that are easy to understand, says Todd Whitthorne, executive director at Cooper Wellness. “If you have fears about a particular condition, tell the doctor, who can investigate your concerns and decide whether they're founded. Ask when test results will be available and how you’ll be told about them.” The patient is responsible for calling in for test results, he says. Some doctors don't report them unless there's a problem. And in a busy office, matters can be overlooked. “You don't want to be left wondering, so pick up the phone and call them,” Whitthorne advises.

Following an exam, the doctor may recommend updating vaccinations and may want to screen for certain diseases or discuss making changes for a healthier lifestyle. For example, after his last physical, President Barack Obama was advised to stop smoking.

“When you receive test results, ask the doctor to compare them to results from previous tests to see if any lifestyle modifications are needed,” Whitthorne says. “Even if your cholesterol count or your weight is within an acceptable range, has it shifted much from what it was before?”

The Cooper Clinic has more than a dozen physicians on staff conducting comprehensive physical exams and offering suggestions for good health. After a medical history review, Cooper Clinic exams can include a cholesterol profile, blood count, urinalysis, vitamin D test, body-fat measurement, oral-cancer screening, head-to-toe screening for skin cancer, cardiovascular screening, flexibility test, mammogram, osteoporosis screening, a pap test and a pelvic exam. The exam might also include an electrocardiogram or EKG, exercise-stress testing, brain imaging, nuclear-stress testing, an upper endoscopy and a colonoscopy.

Services during a Cooper Clinic physical can include a computerized analysis of a client's three-day, food intake. Another option is a psychological-stress assessment. After a physical exam, the client has access to one-on-one health guidance with a Cooper coach by telephone.

For more information on Cooper Wellness and their 6-day and 2-day wellness programs go to www.cooperwellness.com or call 972-386-4777.

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MEDIA ADVISORY:

For more information or to arrange an interview with Todd Whitthorne, executive director at Cooper Wellness, please contact Jo Trizila, TrizCom, at (972) 247-1369 or (214) 232-0078.

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