Longevity: Exploring the Science of a Longer, Healthier Life

Written By Adama Diarra, DO, FACP

The Importance of Your Annual Exam: A Comprehensive Guide to Preventive Health Care

By Adama Diarra, DO, FACP

Board Certified Internal Medicine (American Board of Internal Medicine-ABIM)

What is an Annual Exam?

An annual exam is a routine checkup that serves as a foundation for managing your overall health. Also known as a preventive health exam or wellness visit, the annual exam is a crucial opportunity to assess your health status, identify potential health risks, and set goals for maintaining or improving your well-being. Whether you're feeling fine or managing chronic conditions, this yearly visit gives you and your doctor the chance to focus on your long-term health and catch any issues early before they become serious problems.

Why is an Annual Exam Important?

The purpose of an annual exam goes beyond simply treating illness. It's about preventing diseases before they start and optimizing your health so that you can live a long, healthy, and active life. Many serious health conditions, like heart disease, diabetes, and cancer, develop gradually, and without symptoms early on. By seeing your doctor regularly for an annual exam, you increase the likelihood of catching these conditions in their early stages when they are more treatable and manageable.

Prevention is better than cure—this well-known saying is particularly relevant to annual exams. Studies have shown that preventive care, including annual checkups, can improve long-term health outcomes and reduce healthcare costs by avoiding the need for more expensive and invasive treatments later on (Maciosek et al., 2010).

What Does an Annual Exam Include?

An annual exam typically includes three main components: a clinical exam, laboratory tests, and counseling for disease prevention or lifestyle optimization. Here's what you can expect:

1. Patient-Specific Clinical Examination

Your doctor will perform a head-to-toe physical exam tailored to your individual needs and health history. This exam may include:

  • Vital Signs Check: This includes measuring your blood pressure, heart rate, respiration rate, and temperature.

  • Lung Exam: During a comprehensive physical examination, your doctor employs a stethoscope to listen to your heart and lungs, aiming to identify any abnormal sounds that could indicate conditions such as heart disease or lung issues. In the pulmonary assessment, they observe for decreased or absent breath sounds, which may suggest pneumonia, pleural effusion, or lung collapse. The presence of wheezing could indicate airway obstruction, commonly seen in asthma or chronic obstructive pulmonary disease (COPD). Crackles, also known as rales, can be a sign of fluid in the lungs, often associated with heart failure or pneumonia. Additionally, the clinician may detect stridor, a harsh, high-pitched sound that suggests upper airway obstruction. Percussion of the chest may reveal dullness, indicating fluid or consolidation, or hyperresonance, which may suggest air trapping as seen in emphysema (Reyes et al, 2024).

  • Cardiac Exam: In the cardiac examination, the doctor listens for heart murmurs, which are indicative of turbulent blood flow and may point to valve diseases such as aortic stenosis or mitral regurgitation. The detection of gallops, specifically the third (S3) or fourth (S4) heart sounds, can suggest heart failure or diastolic dysfunction. A pericardial friction rub may be heard, indicating pericarditis. The clinician also assesses for jugular venous distention, which suggests elevated right-sided filling pressures, often seen in right heart failure. Evaluation of the pulse and perfusion includes checking for irregular rhythms, weak pulses, or signs of poor circulation, which may be indicative of peripheral artery disease (Rich, J. D., & Rich, S. , 2014).

    It's no secret that the most common cause of death in America (democrats and republicans alike) is heart disease. Even though you would not guess this by the extend of who divided we are these days, it’s still true. In fact, according to the CDC, heart disease causes approximately 695,000 deaths per year in the U.S.  This roughly translate into 1 heart attack every minute in America (CDC,2023). At this rate (every minute), the bodies are everywhere and being younger doesn’t make one heart disease proof in America. The data trends concerning trends in younger patients. A study published in JAMA Cardiology in 2022 found that heart failure-related mortality rates among adults aged 45 and younger have increased significantly in recent years. The research attributes this rise to factors such as increasing rates of obesity, diabetes, and hypertension among younger populations (Khan et al., 2022).

    Because of the seriousness of this, I blindly recommend a screening electrocardiogram (EKG) annually for most of my patients. Sadly, the for-profit health insurance companies and the rationed government-based health insurance push back against this practice (screening EKGs). In my experience, the number reason for denial is that patients must have a qualifying diagnosis in the first place for coverage to be bestowed by the almighty insurance company. There is lot to unpack here and we’ll do a deep dive at a letter newsletter.  

  • Abdominal Exam: During the abdominal examination, the doctor inspects for distention, asymmetry, scars, or visible peristalsis, which may suggest bowel obstruction. Auscultation is performed to assess bowel sounds; absent sounds may indicate ileus or severe peritonitis, while hyperactive sounds could be a sign of bowel obstruction. The presence of bruits, which are vascular murmurs, may suggest conditions such as an aortic aneurysm or renal artery stenosis. Percussion is used to detect shifting dullness, suggesting ascites, or tympany, indicating excessive gas, common in bowel obstruction. Palpation helps identify tenderness, which can suggest conditions like appendicitis, gallbladder disease, or pancreatitis. The detection of enlarged organs, such as hepatomegaly or splenomegaly, may indicate liver disease or infections. Rebound tenderness indicates peritoneal irritation, commonly associated with appendicitis or peritonitis. Palpation may also reveal masses, suggesting tumors, hernias, or bowel obstruction (Cui et al., 2024).

 

  • Skin Check: Skin cancer is the most frequently diagnosed in the USA. This is not melanoma per say but rather nonmelanoma skin cancers (NMSCs), primarily basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). For instance, in the United States, more than 5.4 million cases of NMSC were treated in over 3.3 million people in 2012, yet these cases are not typically included in national cancer registries (Skincancer.org). Your doctor may examine your skin for moles or other lesions that could indicate skin cancer or other issues. Taking pictures is a great idea not only for record keeping. A high quality picture allow comparison in case the lesion changes, can be used for a curb side consult with a dermatologist, and or can used by an AI or algorithm based tool (there are many on the market but I won’t endorse any here) to you and your human clinician.

  • Neurological Exam: The neurological examination assesses reflexes, muscle strength, sensation, coordination, and cranial nerve function to evaluate brain, spinal cord, and peripheral nerve health. Reflex testing helps detect abnormalities such as hyperactive reflexes seen in strokes or diminished reflexes in neuropathy. Muscle strength and tone assessments identify weakness or spasticity, which can signal conditions like stroke, multiple sclerosis, or nerve compression (e.g., sciatica).

    Coordination and balance are evaluated with tests like finger-to-nose movements and gait analysis, revealing issues seen in Parkinson’s disease, cerebellar disorders, or alcohol-related neurological damage. Cranial nerve function is examined to assess vision, facial movements, swallowing, and speech, detecting conditions such as Bell’s palsy or brainstem strokes. Sensory testing checks for nerve dysfunction from diabetes, spinal cord injury, or carpal tunnel syndrome, while brief cognitive assessments help identify early signs of dementia or Alzheimer’s disease. If abnormalities are found, further tests like MRI, CT scans, or nerve conduction studies may be recommended (Johns Hopkins Medicine).

 

Summary of Patient-Specific Clinical Examination

  • Vital Signs Check – Measures blood pressure, heart rate, respiration rate, and temperature.

  • Heart & Lung Exam – Uses a stethoscope to detect abnormal sounds indicating heart or lung conditions.

  • Abdominal Exam – Checks for issues with liver, kidneys, and intestines through palpation.

  • Skin Check – Examines moles and lesions for signs of skin cancer or other conditions.

  • Neurological Exam – Assesses reflexes, muscle strength, and coordination for nervous system health.

1.       Tests

Lab work: Annual exams often include lab work to assess your internal health. While not everyone will need the same tests, some common labs include:

o    Blood Work: This might involve a complete blood count (CBC) to check for anemia, infections, and overall blood health. A metabolic panel can give insights into your liver, kidneys, and electrolyte levels.

o    Cholesterol and Glucose Tests: These tests screen for high cholesterol and diabetes, two risk factors for heart disease.

o    Thyroid Function: Depending on your symptoms and risk factors, your doctor might check your thyroid function, which plays a key role in metabolism and overall health.

Cancer Screenings:

Cancer screenings are tailored to your age, gender, family history, and lifestyle, ensuring the most effective preventive care. Your annual exam is the perfect opportunity to discuss and address your cancer screening needs.

However, since screening guidelines vary based on the type of cancer, we won’t cover them all here. The good news is that we previously explored cancer screening in depth in our last newsletter. If you missed it, you can find all the details at the following link: cancer screening.

3. Counseling for Disease Prevention & Health Optimization

 

One of the most valuable aspects of an annual exam is the personalized counseling provided by your doctor. This is your opportunity to discuss lifestyle habits, health goals, and strategies for staying healthy. Key topics often include:

  • Nutrition & Diet – A balanced diet is essential for disease prevention, helping to lower the risk of diabetes, heart disease, and certain cancers. Your doctor can offer personalized dietary guidance based on your health history and risk factors.

  • Exercise & Physical Activity – Regular exercise supports heart health, mental well-being, and overall longevity. Your doctor can help develop a fitness plan suited to your age, fitness level, and personal goals.

  • Mental Health – If you're experiencing stress, anxiety, or depression, your annual exam is an ideal time to address these concerns. Mental health is a crucial part of overall wellness, and your doctor can provide guidance, resources, or referrals as needed.

  • Smoking & Alcohol Use – Your doctor will discuss tobacco and alcohol consumption and offer support to quit or reduce use, helping to lower your risk of chronic disease and organ damage.

  • Vaccinations & Immunizations – Staying current on vaccines like the flu shot, tetanus booster, and other recommended immunizations helps protect against preventable diseases and supports long-term health.

While these discussions are essential to preventive care, the reality is that a brief 10- to 15-minute visit may not allow time to address everything in detail. To make the most of your appointment, consider preparing a list of questions in advance and sending them through your electronic health record (EHR) messaging system. This allows your doctor to review your concerns beforehand and ensure a more focused, efficient discussion during your visit.

How Does an Annual Exam Optimize Health and Prevent Disease?

Annual exams are especially valuable because they help you stay ahead of potential health problems. Here are some ways your exam can help prevent or manage diseases:

  • Early Detection: Many conditions, like high blood pressure, high cholesterol, and diabetes, often have no symptoms in their early stages. Lab tests and screenings during your annual exam can catch these conditions before they cause serious damage.

  • Customized Health Advice: Everyone is different, and your annual exam allows your doctor to provide personalized advice based on your individual risk factors, family history, and lifestyle.

  • Establishing a Health Baseline: Having regular annual exams helps create a baseline of your health data, making it easier to detect changes or abnormalities in the future.

  • Promoting Healthy Aging: For older adults, annual exams play a key role in managing age-related conditions and preventing falls or other injuries.

According to the U.S. Preventive Services Task Force, preventive services, including regular checkups, can have a significant impact on reducing the risk of certain diseases and improving overall health outcomes (U.S. Preventive Services Task Force, 2019).

Conclusion

Your annual exam is more than just a routine visit—it's a chance to take control of your health, prevent diseases, and make proactive decisions that support a long, healthy life. By undergoing a clinical exam, getting appropriate lab work, and receiving counseling for lifestyle improvements, you're setting yourself up for success. Whether it's adjusting your diet, increasing exercise, or getting an early diagnosis of a health issue, your annual exam provides the roadmap to better health.

Remember, prevention is the key to long-term health, and your annual exam is the cornerstone of preventive care. So, if you haven’t scheduled yours yet this year, it might be time to do so!

References:

  • The Skin Cancer Foundation. (n.d.). Skin cancer facts & statistics. The Skin Cancer Foundation. Retrieved February 1, 2025, from https://www.skincancer.org/skin-cancer-information/skin-cancer-facts/

  • U.S. Preventive Services Task Force. (2019). Guide to Clinical Preventive Services 2019. Agency for Healthcare Research and Quality. https://www.ahrq.gov/prevention/guidelines/guide/index.html