Wellness and Prevention in an Era of Patient Responsibility
As the U.S. healthcare system has evolved, people have had to take a more active role in the care they and their loved ones receive. Fortunately, taking more responsibility for understanding your care and communicating with your healthcare provider can help extend your healthy years.
Preventive medicine is one area of healthcare in which all consumers can exercise more responsibility and control. Getting regular screening tests for common health problems is a simple and effective first step.
Screening tests can give you and your healthcare provider the information needed to identify health risks and take preventive measures before they become more serious problems. Screening tests include self-checks, clinical exams, non-laboratory tests (such as imaging tests), and laboratory tests. The focus here is on laboratory screening tests.
Getting routine tests performed even though you have no symptoms can help detect problems early and help you benefit from easier and more effective treatment. It can sometimes even prevent disease. It’s easy to take these tests for granted, but their power to keep you healthier longer should not be underestimated.
For example, if you are at-risk for type-2 diabetes, catching the disease in its early stages may help you prevent or manage the condition with diet and exercise alone. Without early detection by a routine screening test, you could miss the opportunity to prevent diabetes, which could result in serious complications and a need for more intensive diabetes management.
To get the maximum benefit from preventive medicine, you should approach wellness visits prepared to discuss your health outlook and family and medical history with your healthcare provider. The decision whether to have certain screening tests performed will depend on your own risk tolerance. Whether to take advantage of laboratory screening is ultimately your decision, but starting from a base of health knowledge will help you communicate with your care provider about what’s best for you.
Screening Tests for a Healthier Life
Screening tests play a large role in preventive medicine and are an important part of a physical exam. They have two major benefits:
- Encouragement to make positive changes: Even if you are healthy, you can learn to guard your health more closely if a test reveals, for example, a borderline high cholesterol level. Test results can help you take steps to reduce your risk and the likelihood that you will develop a life-threatening disease or disabling condition.
- Early detection: Even before symptoms are recognized or increased risks are identified, screening tests help detect disease in its early and most treatable stages.
The Screening section on this site summarizes, by age group, the recommendations of some of the leading authorities for conditions for which laboratory screening tests are available. There are other important conditions that you may be screened for but that don’t involve laboratory testing. Please keep in mind that for many tests, no national consensus exists on their value as a mechanism for preventing disease and living a healthier life, so it is important to consult with your doctor to determine which tests are right for you. In addition, recommendations for newborn screening currently vary by state.
Developing a Basic Health Competency
To get the best medical care available today, consumers need to develop basic knowledge and skills related to their medical care. Doing so will help you oversee your preventive care and get the most from your screening tests.
Even more important than knowing which tests to have and when to have them is the knowledge of what are your major risks and how you can prevent the diseases you are at risk of developing.
Understanding your personal risks and managing your preventive care will seem much less daunting if you have developed good overall health literacy. Health literacy is your ability to obtain, process, and understand the basic information necessary to make health decisions. It involves a diverse set of skills, including understanding graphs, making basic calculations, and obtaining, evaluating, and applying information.
Specifically, to take full advantage of your screening tests and obtain the best preventive care, you should:
- Know your family health history and make sure your doctor knows it.
- Know which immunizations you have had and make sure your doctor also knows.
- Know which health problems you are at risk for and make sure you tell your doctor.
- Increase your awareness of medical tests that are of value to you.
- Talk to and work with your health care provider to maintain your health; this includes identifying lifestyle changes that will improve your health and encouraging your health care provider to discuss screening tests with you.
- Review your health insurance plan and talk to your insurance provider; know what your health care plan does and does not cover and understand the processes for getting referrals and reimbursements.
- Always be willing to ask your health care providers questions or suggest clarification if they say something you don’t understand.
- Remind yourself that it’s your health and you owe it to yourself to fully comprehend your care.
You can still rely on your doctor to tell you what tests are most worthwhile for you, but you will get the best preventive care if you approach your visits from a base of knowledge about yourself and your health.
If you still feel you are struggling with understanding medical information, it is important that you seek guidance from your healthcare provider, family, and resources like the one you are reading now.
Customized, Periodic Health Exams
During a routine health exam, in addition to the screening tests discussed earlier, the following are usually checked:
- Blood pressure
- Height and weight
- Immunization status (The Centers for Disease Control and Prevention recommend immunizations based on age, occupation, health status, and other factors.)
- Age-appropriate vision and hearing tests
However, the days of the generic annual physical are over. Today, preventive services are customized, taking into account your health status, risk factors, and personal and family health history. Though you are still seeing your healthcare provider for a periodic health exam, you may not receive the same tests as everyone else, or even the same tests you had last year.
Many – but not all – health care plans cover preventive services. The extent of coverage varies, so you should confirm exactly what coverage your plan provides for these services.
It is your responsibility to schedule these health exams, although your provider will recommend the necessary frequency.
Listen and Learn
Once your healthcare provider has assessed your health status and reviewed your test results, it is time to listen to his or her counsel and recommendations. This is a very important part of the prevention process; you will probably need to take notes and may have follow-up questions. Don’t be afraid to ask for clarification if you don’t understand something. You can expect to be counseled about changes you can make regarding things you have control over.
Discussing your lifestyle, activities, and behaviors that affect your health with your healthcare provider will help you prevent illness. Likely topics are injury prevention, nutrition and exercise, substance abuse (including alcohol, tobacco, and drugs), and activities that place you at higher risk, including, for example, your occupation and sexual activities. Listen for what changes you can make and discuss areas that present difficulty. Even small changes can be the beginning of better health. Some of the areas in your control are:
- Using tobacco products
- Seat belt use
- Abuse of alcohol or other drugs in general and particularly while driving
- Physical activity
- Eating habits and diet
- High risk sexual practices
Prevention is Your Choice
It is up to you to choose to have regular screening tests. While there is expert consensus about many areas of screening, there are some areas—like breast and prostate cancer screening—where expert opinions have differed, or changed, in recent years. In the case of some screening tests, you and your healthcare provider will have to work together, considering your risks and personal preferences, to determine which are best for you.
Overall, the benefits of regular screening are compelling: when disease is detected early, your treatment is likely to be more effective and economical and your quality of life is usually better.
Your healthcare provider can help you understand what you are at risk for and what you can do about it, if you make time for routine screening tests as part of a regular a health exam.
NOTE: This article is based on research that utilizes the sources cited here as well as the collective experience of the Lab Tests Online Editorial Review Board. This article is periodically reviewed by the Editorial Board and may be updated as a result of the review. Any new sources cited will be added to the list and distinguished from the original sources used.
Sources Used in Current Review
National Network of Libraries of Medicine. Health Literacy. Updated June 7, 2011. Available online at http://nnlm.gov/outreach/consumer/hlthlit.html through http://nnlm.gov. Accessed December 21, 2011.
Centers for Disease Control and Prevention. Vaccines: Recs/Schedules/Immunization Schedules main page. Available online at http://www.cdc.gov/vaccines/recs/schedules/default.htm through http://www.cdc.gov. Accessed April 2012.
Centers for Disease Control and Prevention. Health Living. Available online at http://www.cdc.gov/HealthyLiving/ through http://www.cdc.gov. Accessed April 2012.
MedlinePlus Medical Encyclopedia. Physical exam frequency. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/002125.htm. Accessed April 2012.
Sources Used in Previous Reviews
United States Centers for Disease Control and Prevention. Death: preliminary data for 1999. June 26, 2001. Available online at http://www.cdc.gov/nchs/fastats/deaths.htm through http://www.cdc.gov. Accessed July 6, 2001. Reaccessed April 2012. (Deaths and Mortality: Data for the U.S., 2009.)
American Cancer Society. Skin cancer: Nonmelanoma resource center. Detection and symptoms. Available online at http://www3.cancer.org/cancerinfo through http://www3.cancer.org. Accessed June 19, 2001. (No longer available)