Medical Services
Our Comprehensive Executive Physical Exam
- We recommend that all of our patients, annually, get a good old-fashioned, hands on, screening "Comprehensive Executive Physical Exam" performed by your doctor which provides you with a complete comprehensive health assessment of your current state of health, which allows you to manage your future health needs and can help identify cancer, diabetes, thyroid disease, high cholesterol, leukemia, anemia, parasites, kidney or liver disease, and other diseases that may not have symptoms but when caught early can result in better health.
- This assessment is personalized & gender-specific, & includes a series of sophisticated diagnostic tests.
- It is also a good opportunity to address risk factors, health or life concerns and review the necessary prevention interventions that you may need.
- It also gives us a chance to sit down and get to know you better and improve our doctor-patient relationship.
- At Prime Healthcare Providers, we think in terms of individuals not populations. It is guided not by what has been deemed cost effective in any given population, but instead it is driven by an individual’s unique risks & balanced by available resources to effectively detect preventable illnesses. As a result, a test that may not be cost effective for the society at large in detecting preventable illnesses is still offered in our examination.
We Still Do Them
- This type of screening comprehensive annual physical exam, as we once knew it, and which you have come to expect, is no longer a covered benefit by most insurance companies (Medicare and Commercial insurance), but the good news is that we still do them as part of your membership fee.
- Your insurance company does not feel that it is "medically necessary" and have replaced it with what they call a "Wellness Visit", which provides for "Covered Preventative Services" (as defined by the Affordable Healthcare Act) but does not include a hands on examination by your doctor. It is primarily, just a brief review of your medical history, a few simple measurements and tests and is a covered benefit and is billed to your insurance company.
- Let me explain in detail, the difference.
The Covered Preventative Services (Wellness Services) that are paid for by your insurance are as follows: A standard insurance wellness visit is a 10 minute visit with a medical assistant that does not touch on very much besides screening for basic items and some tests.
- Review of:
- Past Medical History;
- Active Problem List;,
- Chronic Problem List;
- Medications;
- Family History;
- Social History;
- Substance Use History: Tobacco Use, Alcohol Use, Other substances;
- Measurements of: Height, Weight, Blood Pressure, Pulse, BMI;
- For Women: See Measurements plus Mammogram, Pelvic Exam,
Pap Smear. We do not perform these services in our office and you will need to see your Gynecologist for these. - For Men: See Measurements plus a Rectal exam and PSA (where indicated);
- Lab Tests: * - CBC, Cholesterol, Glucose, Basic Metabolic Profile, Cholesterol, Thyroid Tests, PSA for Males >50; Vitamin D, Hemoglobin A1C
- Screening Tests: * - EKG, Hearing, Breathing
- Recommended Immunization Schedule - Vaccines: Influenza, DT, Pneumonia, Hepatitis B, Shingles;
- Referrals where necessary for Gynecology Services and Colon Cancer Screening;
- Referrals for Nutrition Services where indicated;
* May be covered by some plans
What is NOT included in your Wellness Services are the following:
(but is included in a Comprehensive Executive Physical Exam and is performed by a doctor)
- A Comprehensive Multi-System Head Toe Physical Exam performed by your Doctor - see below
- A Comprehensive System Review to look for any clues that may signal a more serious problem.
- A Comprehensive or Interval Past Family, Social History that is needed to fully understand your condition(s).
- A Comprehensive History of Pertinent Risk Factors that may significantly impact your chance of developing a serious complication to one of them.
- Dealing with Problem Focused issues such as high blood pressure, diabetes, high cholesterol, various aches and pains and other various complaints.
- Dealing with Current or Past Complaints or Present Illnesses such as managing your chronic conditions or refilling medications.
- Medical Decision Making concerning your health which your doctor does after taking into consideration all of the above factors. This is the toughest part of the job because it takes a lot of brain power to get it right.
- Treatment Plan preparation and ordering any other necessary diagnostic studies.
| Service | Commercial Insurance Wellness Visit | Medicare Annual Wellness Visit | OUR PHYSICAL |
| Physical Examination of the Patient by the doctor |  |
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| Comprehensive Review of Systems - Current Health | |
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| A Comprehensive or Interval Past Family, Social History | |
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| Comprehensive History of Pertinent Risk Factors | |
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| Address any new medical problems - problem focused | |
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| Address any Chronic Medical problems | |
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| Medical Decision Making and Treatment Plan | |
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| Brief Review of Systems, Family, Social History, Medication Lists, Past History, Chronic and Active Problem List | |
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Vital Signs and BMI Performed |
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| Male Genital Exam/Prostate Exam | |
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Female Genital Exam/Pap Smear |
Done by Gyn | Done by Gyn | Done by Gyn |
| Diet and Nutrition Info Provided | Only for high risk | |
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| STD screening/Prevention | Only for high risk | |
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| Vaccination History and Updates | |
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| Screening - Alcohol Abuse | |
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| Screening - Obesity | |
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| Screening - Tobacco | |
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| Screening - Diabetes | Only if you have high blood pressure | |
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| Screening - Cholesterol | For high risk only | |
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| Screening - Depression | |
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| Screening - Colorectal Cancer (over age 50) | |
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| Screening - Memory Loss | |
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| Review Functional Ability and Safety | |
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| Evaluate need for daily Aspirin | |
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| Review Necessary Age Appropriate Screenings | |
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| Establish List of Current Medical Providers | |
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The Physical Exam as Performed by Your Doctor
The traditional physical exam is an essential part of any doctor's visit but varies from doctor to doctor, as to how it is performed. A doctor may be thorough or brief, according to his or her personal style and your individual circumstances. We take the thorough approach and perform the following.
- History. This is your chance to mention any complaints or concerns about your health. We will also likely quiz you about important behaviors, like smoking, excessive alcohol use, sexual health, diet, and exercise, We will also check on your vaccination status and update your personal and family medical history.
- Vital Signs. These are some vital signs that we check for:
Blood pressure: less than 120 over 80 is a normal blood pressure. We define high blood pressure (hypertension) as 140 over 85-90 or higher.
Heart rate: Values between 60 and 100 are considered normal. Many healthy people have heart rates slower than 60, however.
Respiration rate: Around 16 is normal. Breathing more than 20 times per minute can suggest heart or lung problems.
Temperature: 98.6 degrees Fahrenheit is the average, but healthy people can have resting temperatures slightly higher or lower. - General Appearance. We gather a large amount of information about you and your health just by watching and talking to you. How is your memory and mental quickness? Does your skin appear healthy? Can you easily stand and walk?
- Heart Exam. By listening to your heart with a stethoscope, we might
- detect an irregular heartbeat, a heart murmur, or other clues to heart disease.
- Lung Exam. Using a stethoscope, we listen for crackles, wheezes, or decreased breath sounds. These and other sounds are clues to the presence of heart or lung disease.
- Head and Neck Exam. Opening up and saying "ah" shows off your throat and tonsils. The quality of your teeth and gums also provides information about your overall health. Ears, nose, sinuses, eyes, lymph nodes, thyroid, and carotid arteries are also examined.
- Abdominal Exam. We can use a range of examination techniques including tapping your abdomen to detect liver size and presence of abdominal fluid, listening for bowel sounds with a stethoscope, and palpating for tenderness.
- Neurological Exam. Nerves, muscle strength, reflexes, balance, and mental state are assessed.
- Dermatological Exam. Skin and nail findings could indicate a dermatological problem or disease somewhere else in the body.
- Extremities Exam. Your doctor will look for physical and sensory changes. Pulses can be checked in your arms and legs. Examining joints can assess for abnormalities.
- Male Physical Exam
An annual physical exam for men might also include:
Testicular exam: We will check each testicle for lumps, tenderness, or changes in size. Most men with testicular cancer notice a growth before seeing a doctor.
Hernia exam: The famous "turn your head and cough" checks for a weakness in the abdominal wall between the intestines and scrotum.
Penis exam: We may notice evidence of sexually transmitted infections such as warts or ulcers on the penis.
Prostate exam: Inserting a finger in the rectum lets us feel the prostate for its size and any suspicious areas. - Female Physical Exam
A woman's annual exam might include:
Breast exam. Feeling for abnormal lumps may detect breast cancer or benign breast conditions. The doctor will also check the lymph nodes in the underarm area and look for visual abnormalities of the breasts. - Pelvic exam: Although we do not do these exams, you gynecologist will and it allows an examination of the vulva, vagina, and cervix. Routine checks for sexually transmitted infections are often done. A Pap test can screen for cervical cancer.
