What Actually Happens at an Annual Physical Exam

The annual physical exam is one of the most valuable — and most underutilized — tools in preventive medicine. Many people skip it when they feel fine, not realizing that's exactly when it's most useful.

The goal of a physical isn't to find problems after they've caused symptoms. It's to catch risk factors, imbalances, and early disease before they become serious — when they're still easy to address.

Here's a complete breakdown of what we do at an annual physical at Roth Family Medicine & Mental Health, and how to make the most of your visit.

Getting the most from your annual physical starts before you walk through the door. Here's what to bring or have ready:

• A list of all current medications — prescription, over-the-counter, vitamins, and supplements with dosages
• Your medical history — past diagnoses, surgeries, hospitalizations
• Family history — especially first-degree relatives with heart disease, cancer, diabetes, or mental illness
• Your questions — write them down so you don't forget in the moment
• Recent records from other providers if you've been seen elsewhere

If you're a new patient, arrive 15 minutes early to complete intake paperwork.

Your physical begins with a comprehensive review of your health history. We'll discuss:

• Current symptoms or concerns — even vague ones like fatigue, sleep problems, or mood changes
• Lifestyle factors — diet, exercise, alcohol and tobacco use, sleep quality, stress levels
• Mental health — depression, anxiety, and cognitive function are part of whole-person care
• Preventive care history — when you last had a colonoscopy, mammogram, Pap smear, or other screenings
• Immunization status — whether you're up to date on recommended vaccines

This conversation is as important as any test we run. The more honest and complete your answers, the more useful your physical will be.

We measure:

• Blood pressure — the most important cardiovascular risk factor, and often elevated without any symptoms
• Heart rate and rhythm
• Respiratory rate
• Temperature
• Height, weight, and BMI
• Oxygen saturation

We also calculate your waist circumference in many cases — a better predictor of metabolic risk than BMI alone.

A thorough physical exam includes:

We check your eyes for signs of hypertensive or diabetic changes, examine your ears and throat, assess your lymph nodes, and check your thyroid gland for enlargement or nodules.

We listen to your heart for murmurs or irregular rhythms and assess your peripheral pulses.

We listen to your lungs for wheezing, crackles, or other abnormal sounds.

We palpate your abdomen to assess organ size, tenderness, and any masses.

We assess your range of motion, joint health, and any areas of pain or limitation.

A brief neurological screen assesses reflexes, coordination, and cognitive function.

We examine your skin for suspicious lesions, rashes, or changes that warrant further evaluation.

Depending on your age and history, this may include a breast exam, pelvic exam, or testicular exam.

Bloodwork is a cornerstone of the annual physical. A standard panel typically includes:

• Complete blood count (CBC) — checks for anemia, infection, and blood cell abnormalities
• Comprehensive metabolic panel (CMP) — kidney function, liver function, electrolytes, blood sugar
• Lipid panel — total cholesterol, LDL, HDL, triglycerides
• Hemoglobin A1c — a 3-month average of blood sugar, screening for diabetes and prediabetes
• Thyroid-stimulating hormone (TSH) — screens for thyroid dysfunction

At Roth Family Medicine, we often expand this panel based on your symptoms and risk factors — adding vitamin D, ferritin, inflammatory markers, or hormone levels when clinically indicated. We believe in going beyond the minimum to give you a complete picture.

Depending on your age, sex, and risk factors, we'll discuss and order appropriate cancer screenings:

• Colorectal cancer — colonoscopy starting at age 45 (or earlier with family history)
• Cervical cancer — Pap smear and HPV testing per current guidelines
• Breast cancer — mammography discussion starting at age 40
• Lung cancer — low-dose CT scan for current or former heavy smokers aged 50–80
• Skin cancer — visual skin exam and referral to dermatology when indicated
• Prostate cancer — PSA discussion for men over 50 (or 40–45 with risk factors)

We review your vaccination history and administer or recommend any that are due, including:

• Annual influenza vaccine
• Tdap (tetanus, diphtheria, pertussis) every 10 years
• Shingles vaccine (Shingrix) for adults 50+
• Pneumococcal vaccines for adults 65+
• COVID-19 boosters per current recommendations

Mental health is part of physical health — and we screen for it at every annual exam. We use validated tools including:

• PHQ-9 — screens for depression severity
• GAD-7 — screens for generalized anxiety
• AUDIT-C — screens for alcohol use disorder

If screening suggests a concern, we discuss it openly and without judgment. We offer a full spectrum of mental health services at our practice, from medication management to TMS and ketamine therapy.

At the end of your physical, we'll review your results, discuss any findings, and create a clear plan. This might include:

• Lab results to review at a follow-up appointment
• Referrals to specialists
• Lifestyle recommendations
• Medication adjustments
• Scheduled screenings

You'll leave with a clear understanding of where your health stands and what steps to take next.

At Roth Family Medicine & Mental Health, we take the time to do annual physicals right — not a 10-minute checkbox visit, but a thorough evaluation that gives you real information about your health.

Book your annual physical online or call us at (208) 904-4705. We're accepting new patients.