Preventive Care in Pocatello: What Your Annual Physical Should Actually Include

By Kyle Roth, FNP-BC, APRN, MSN, MHA | Roth Family Medicine and Mental Health | Pocatello, Idaho

The annual physical has a reputation problem. Many patients leave their yearly visit feeling like they got a cursory once-over — blood pressure checked, a few questions asked, maybe some labs ordered — without a clear sense of what was actually assessed or why.

A well-executed preventive care visit is one of the most valuable investments in long-term health available. It's the opportunity to catch problems before they become serious, identify risk factors before they cause disease, and build the kind of longitudinal relationship with a provider that makes all subsequent care better.

This guide explains what a comprehensive preventive care visit at Roth Family Medicine includes — and why each component matters.

The most important part of any preventive visit is the history — a systematic review of your health, your family's health, your lifestyle, and your concerns. This includes:

Medical history: Current conditions, past surgeries, hospitalizations, and significant illnesses.

Family history: First-degree relatives (parents, siblings, children) with heart disease, cancer, diabetes, mental illness, and other heritable conditions. Family history is one of the most powerful predictors of individual risk.

Medication review: All prescription medications, over-the-counter medications, supplements, and vitamins. Drug interactions, inappropriate medications for age, and opportunities for deprescribing are assessed.

Social history: Tobacco use, alcohol use, recreational drug use, occupation, living situation, relationship status, and social support. These factors are among the strongest determinants of health outcomes.

Mental health screening: Depression (PHQ-9), anxiety (GAD-7), and substance use screening are standard components of preventive care. Mental health conditions are among the most common and most undertreated health problems in Southeast Idaho.

Review of systems: A systematic review of symptoms across all organ systems to identify problems that haven't been brought up.

Blood pressure: Hypertension affects approximately 47% of American adults and is a major risk factor for heart disease, stroke, and kidney disease. It is often asymptomatic — the "silent killer." Regular measurement is essential.

Body mass index (BMI) and waist circumference: Obesity is associated with diabetes, cardiovascular disease, sleep apnea, depression, and multiple cancers. Waist circumference is a particularly useful measure of metabolic risk.

Heart rate and rhythm: Atrial fibrillation — a common arrhythmia that dramatically increases stroke risk — can be detected on physical examination.

Respiratory rate and oxygen saturation: Baseline assessment and screening for respiratory conditions.

Physical examination: A systematic examination of the cardiovascular system, lungs, abdomen, skin, lymph nodes, and other systems appropriate to age and risk factors.

Comprehensive metabolic panel: Kidney function, liver function, electrolytes, and blood glucose. Identifies diabetes, kidney disease, liver disease, and electrolyte abnormalities.

Fasting lipid panel: Total cholesterol, LDL, HDL, and triglycerides. Cardiovascular disease is the leading cause of death in the US; lipid screening is foundational to cardiovascular risk assessment.

HbA1c: Glycated hemoglobin reflects average blood glucose over 3 months. Screens for diabetes and prediabetes.

Complete blood count (CBC): Screens for anemia, infection, and blood cell abnormalities.

Thyroid-stimulating hormone (TSH): Thyroid dysfunction — both hypothyroidism and hyperthyroidism — is common, often asymptomatic, and highly treatable. Hypothyroidism is a particularly important cause of depression, fatigue, and cognitive impairment.

Vitamin D (25-OH): As discussed in our vitamin D article, deficiency is extremely common in Idaho and associated with depression, fatigue, immune dysfunction, and bone disease.

Fasting insulin: Insulin resistance — the precursor to type 2 diabetes — is not detected by standard glucose testing. Fasting insulin identifies insulin resistance years before diabetes develops.

Inflammatory markers (hs-CRP): Elevated CRP predicts cardiovascular risk and, as discussed in our inflammation-depression article, identifies inflammatory contributors to depression.

Hormonal assessment (age and symptom-appropriate): Testosterone in men with symptoms of deficiency; estradiol, FSH, and progesterone in women with perimenopausal symptoms; DHEA-S as a marker of adrenal function.

Sexually transmitted infection screening: HIV, hepatitis B, hepatitis C, and other STIs as appropriate to risk factors.

Colorectal cancer: Colonoscopy starting at age 45 (or earlier with family history or symptoms). Colorectal cancer is the second leading cause of cancer death in the US and is highly preventable with screening.

Cervical cancer: Pap smear every 3 years (or every 5 years with HPV co-testing) for women ages 21–65.

Breast cancer: Mammography annually or biennially starting at age 40–50 depending on risk factors and patient preference.

Lung cancer: Low-dose CT scan annually for adults ages 50–80 with a 20 pack-year smoking history who currently smoke or quit within the past 15 years.

Skin cancer: Annual skin examination for patients with significant sun exposure history, fair skin, or personal/family history of skin cancer.

Prostate cancer: PSA testing discussion for men ages 55–69, with shared decision-making about benefits and risks.

For adults without established cardiovascular disease, a 10-year cardiovascular risk assessment using the Pooled Cohort Equations (or similar tool) guides statin therapy decisions. This calculation incorporates age, sex, race, blood pressure, cholesterol, diabetes status, and smoking history.

Coronary artery calcium (CAC) scoring: A low-radiation CT scan that directly measures calcified plaque in the coronary arteries. For patients in the intermediate risk range, CAC scoring can meaningfully refine risk assessment and guide treatment decisions.

Preventive care includes a review of immunization status:

• Influenza: Annually for all adults
• COVID-19: Updated formulations as recommended
• Tdap/Td: Tetanus-diphtheria-pertussis booster every 10 years
• Shingles (Shingrix): Two-dose series for adults 50+
• Pneumococcal: For adults 65+ and younger adults with certain conditions
• Hepatitis B: For unvaccinated adults
• HPV: For adults through age 26 (and some adults 27–45 with shared decision-making)

At Roth Family Medicine, mental health is integrated into every preventive visit — not treated as a separate concern. We screen for:

• Depression (PHQ-9)
• Anxiety (GAD-7)
• Alcohol use (AUDIT-C)
• Substance use
• Sleep quality
• Cognitive function (in older adults)

For patients who screen positive, we discuss treatment options including medication management, therapy referral, and advanced treatments (ketamine, TMS) for treatment-resistant cases.

Beyond standard preventive care, our functional medicine approach includes assessment of:

• Nutritional status: Vitamin D, B12, folate, iron, magnesium, omega-3 index
• Hormonal optimization: Not just "normal range" but optimal levels for wellbeing
• Gut health: History of antibiotic use, digestive symptoms, microbiome-relevant dietary patterns
• Inflammatory burden: hs-CRP, metabolic markers
• Stress and resilience: HPA axis function, sleep quality, social support

The goal is not just the absence of disease but genuine optimization of health and wellbeing.

Roth Family Medicine serves patients throughout Southeast Idaho including Pocatello, Chubbuck, Blackfoot, American Falls, and surrounding communities. We offer comprehensive preventive care visits that integrate family medicine, mental health, and functional medicine in a single practice.

To schedule: 208-904-4705 | www.rothfamilymed.com | ZocDoc online booking available.

Medical Disclaimer: This content is for educational purposes only. Screening recommendations vary based on individual risk factors and should be discussed with your provider.

Kyle Roth, FNP-BC, APRN, MSN, MHA | Roth Family Medicine and Mental Health | Pocatello, Idaho | 208-904-4705 | www.rothfamilymed.com