Even as doctors and the healthcare industry at-large encourage wellness programs aimed at keeping patients out of doctors’ offices and hospitals, many people still hold the traditional belief that doctors treat illness, not help prevent it.
“The most important tools we have in healthcare are not only our medicines, but screening tools and lab tests, which can give us insight into a person’s health even before they get sick,” said Rachel Vallejo, M.D., a family medicine physician with Baptist Health Primary Care | Homestead.
Health History and Vital Signs
Dr. Vallejo says the tools she finds most helpful in her work include the medical, social and family history of her patients, as well as their vital signs, such as blood pressure and heart rate. She captures all this valuable information from her patients at their annual wellness exam, which she says enables her to best manage their overall health.
“We can discover many things during the annual exam,” she said. “Most patients feel well for their annual exam, so it gives us the opportunity to focus on identifying risk factors and discussing ways to optimize wellness.”
Depending on the age of the patient, what his or her history and vital signs reveal about risk factors and whether any bothersome symptoms are uncovered during the annual exam, Dr. Vallejo will order the appropriate lab tests, health screenings or imaging studies to best understand where underlying health problems exist or are likely to arise.
Blood provides a window into our health, showing hidden risks and detecting some diseases, especially in their early stages, before a person experiences any symptoms.
“Second to patients’ health history, I rely on blood tests to give me a picture of most people’s health,” Dr. Vallejo said.
Typical blood work includes a CBC, or complete blood count, which measures the number of red blood cells, hemoglobin, white blood cells and platelets in the blood. Too few red blood cells that carry oxygen to your cells, Dr. Vallejo says, means you have low hemoglobin, or anemia. Too many white blood cells can indicate an infection in the body, and too few signal a potential problem with the immune system. Platelets help with clotting to prevent excessive bleeding, but too many in the blood may suggest the presence of certain types of cancer or a higher risk for heart attack or stroke.
For some patients, Dr. Vallejo orders a blood test to take a closer look at chemicals present in the blood. These include:
- Renal enzymes to determine kidney function
- Liver enzymes
- Glucose, or blood sugar, levels
Dr. Vallejo also checks for lipids, or fats, such as cholesterol; A1C levels, especially in people who are over 40, obese and have diabetes or pre-diabetes; and hormones, such as thyroid stimulating hormone or TSH.
The level of these substances in the blood can reveal risk factors for cardiovascular disease, diabetes, hormonal imbalances, organ dysfunction and cancer.
An in-office urine test may also be administered so that Dr. Vallejo can check for protein or infection in the urinary tract. It is also important when someone has hypertension, diabetes or pre-diabetes to evaluate kidney function. Other urine tests can detect the presence of some sexually transmitted diseases, including gonorrhea and chlamydia, in sexually active individuals.
Pap Test for Women
Dr. Vallejo’s female patients who are 21 years old or older with an average risk of developing cervical cancer receive a Pap test every three years, following the 2018 U.S. Preventive Services Task Force (USPSTF) guidelines. She also talks to her female patients about having an HPV (human papillomavirus) screening every 5 years starting at the age of 30.
Prostate Exam for Men
In general, for male patients who are 50 years old or older with average risk of developing prostate cancer, Dr. Vallejo follows the American Cancer Society guidelines and recommends having a prostate-specific antigen (PSA) blood test. This test may be accompanied by a digital rectal exam to check for lumps or hard areas of the prostate that may indicate prostate cancer.
Dr. Vallejo also talks with her patients about having the following routine screenings recommended by clinical guidelines and aimed at certain age groups.
- Yearly mammograms for women between 40-54 with an average risk of developing breast cancer following American Cancer Society’s Breast Cancer Screening Guidelines.
- Colonoscopy every 10 years beginning at age 50 for men and women with average risk of developing colon cancer. Other stool-based tests, such as a fecal occult test, a fecal immunochemistry test (FIT) and a stool DNA test, such as Cologuard, can also be used as screening tools for the detection of colon cancer.
Dr. Vallejo also advises her patients about appropriate vaccinations to prevent serious infections such as the flu, pneumonia, shingles, whooping cough and now COVID-19.
The Importance of an Annual Exam
“It’s extremely important to have an annual exam,” Dr. Vallejo said. “So many problems can be detected in their earliest stages during routine annual exams. Often people in their late thirties and early forties forego these appointments because they feel well and don’t have time. Then, when they get around to it in their fifties, we see problems that may have been avoided.”
Find a PCP
Dr. Vallejo encourages people to establish a relationship with a primary care physician who will get to know their health over time, so that troubling changes are apparent early on.
“Primary care is the first steppingstone to everywhere else,” she said. “Primary care physicians have the most comprehensive look at a person’s health. We pull together findings, recommendations and treatments from specialists and make sure we’re connecting all the dots for our patients.”
While it may be easy to put off care until it’s needed, Dr. Vallejo suggests investing time in finding a primary care physician when you’re well to help prevent the need for care later. “Everyone should make that time,” she said.