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Posted on Thu, Aug 12, 2010 : 10:23 a.m.

Annual physical exams: The importance of caring for the whole patient



Sarah Lacy, MD

A girl between 13 and 14 years old came in to see me for her annual physical exam because she wanted to play soccer. This young girl had lost quite a bit of weight, leading me to believe she had an eating disorder. Her parents hadn’t noticed the weight loss. Looking at the growth chart highlighted significant weight loss in a short period of time.

Without charting her height and weight over time the weight loss would have gone undetected. The physical exam needed to give the girl permission to play soccer was only a small portion of the visit.

Annual physical exams open up conversations about topics that are difficult for adolescents to discuss, allowing physicians to care for the overall health of their patients.

Due to varying sports seasons, state-mandated requirements and time constraints, sometimes parents and student athletes turn to a quick, standalone sports physical to be approved for participation. Sports physicals, however, should not replace an annual physical exam for overall health. As a pediatrician, I emphasize the importance of an annual physical exam for all of my patients, especially teenagers.

The biggest difference between a standalone sports physical and an annual physical exam is the focus on whole-patient care. In addition to the actual physical exam, I get to know my patients by asking them personal questions and talking to them about issues unrelated to sports. Discussing personal topics can be very helpful for teenagers who may not feel comfortable talking to their parents about certain subjects. The physician provides an outlet for the teen to open up, helping to identify issues at school, depression or anxiety problems, along with any other mood-related issues. Parents open up to physicians as well, making comments such as, “I want to talk to my child about sex, I just don’t know how.” I take on the role of mediator, doing my best to open up the lines of communication between patients and parents.

Topics every adolescent annual physical exam should cover include:

1. Risk-taking behaviors - drugs, alcohol, teen pregnancy 2. Mental health - issues such as anxiety and depression 3. Bike safety 4. TV time 5. Immunization 6. Growth development 7. Nutrition - looking at what their diet consists of, screening for cholesterol if needed

What I find equally as important for my patients is laying a strong foundation for their adult health care. Adolescents are off to a great start by coming in for their annual exam each year with a parent and establishing a medical history. It teaches them that going every year for a physical exam, no matter how old they are, is an important part of taking care of themselves.

Sarah Lacy, MD, is a board-certified pediatrician practicing at IHA Pediatric Healthcare - Canton. She has a special interest in behavioral problems and adolescent medicine. IHA Pediatric Healthcare - Canton is located in the IHA Health Center at 49650 Cherry Hill Road, Suite 210, Canton, MI 48187. Dr. Lacy can be reached at 734-398-7899. For more information please visit



Fri, Aug 13, 2010 : 9:57 a.m.

Thank you so much for this valuable information. My daughter is 10 so this information is wonderful and timely for our family. Thanks so much and have a great summer.