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May is Health Screening month and it’s just around the corner, so let’s address what testing you should include with your next annual medical exam.

An annual physical with your doctor is your chance to identify how you are aging, how to increase your energy and mental sharpness, plus how to prevent cancer, memory loss, and heart disease. Yet too often, this opportunity is replaced with a quick blood pressure and weight check, brief lab work with results you might not even see, a quick listen to your heart, a pap smear or prostate check (and maybe not these either), and too little time to ask questions on things that are important.

Part of the challenge is that medical insurance does not normally pay to assess how you age, how to improve your quality of life, or how to prevent a future health problem, despite that this may be incredibly important to you. It does cover the diagnosis and treatment of a disease, with treatments that have been proven to be cost-effective. Sadly, there is an ongoing debate between doctors and health systems as to whether we should stop offering annual physicals altogether.

Your annual evaluation should clarify how you are aging, help you to achieve peak performance, identify the long-term health risks that you face, and give you the tools to avoid those same threats. Your yearly doctor’s appointment could be your opportunity to shift from:

  • Tired,,,,,,to Energized
  • Mentally Foggy,,,,,,to Sharp & Productive
  • Worried About Your Health & Future,,,,,,To Confident that You’ll Live Life to the Fullest

Your annual assessment should cover the following areas:

  • Weight control: identify your body fat percentage, lean mass, and both a short term and long term optimal weight goal
  • Food and nutrient intake: Do you meet your key nutrients needs, and if not what foods and/or supplements could you take to achieve proper nutrient intake
  • Fitness: Assess your strength, flexibility, and aerobic performance.
  • How you are handling stress
  • Blood sugar control
  • Cardiovascular risk, the #1 killer for men and women
  • Brain function and risk for memory loss
  • Cancer Risk: in particular skin, colon, and GYN or prostate
  • And depending on your history, it might also include your exposure to toxins, risk for bone loss and osteoporosis, safety risks, travel history, support systems, immunization status, and more

The minimum laboratory testing that I would suggest would include your fasting blood sugar level (as part of a CMP—chemistry profile), fasting cholesterol profile, inflammation marker (high sensitivity CRP), thyroid function (TSH), blood count (CBC), nutrient levels (such as vitamin D, ferritin, and perhaps vitamin B12 and RBC magnesium), and a measure of how you are handling stress (such as DHEA-S, and/or Heart Math testing). And at least once by age 50-60, bone density testing (DEXA) as well. Make sure to ask for this type of testing at your visit if it isn’t already performed.

Other additional optional testing that you might want to consider, although it may not be covered by insurance, would include: assessing your arterial plaque load (carotid intimal media thickness testing), computerized cognitive testing to assess your brain processing speed, whole blood mercury level, treadmill ECG and VO2max testing, bone density, and clarifying your hormone levels.

I like to offer a detailed head to toe physical every year, but I realize that this seldom occurs in this day and age.

The truth is that this type of comprehensive evaluation takes time, and time with your physician has been rationed in our new health system.

At my clinic, Dr. Tarin Forbes (my new physician partner and the medical director for our clinic) and I typically spend 3-4 hours of one-on-one time with a new patient to complete an evaluation, and the patient is in our office for nearly 7-8 hours. That evaluation includes all the testing noted above, plus nutrition and fitness. We clarify your unique health goals and come up with a realistic plan to achieve those objectives. But the reality is that most doctors don’t offer nutrition and fitness testing in their medical practice.

One option to have an optimal evaluation within a traditional medical setting is to see a nutritionist and exercise physiologist separately prior to your doctor visit and share those results with your doctor.

Have a local nutritionist evaluate your three-day eating plan for nutrient intake. During three typical days, write down everything you eat (breakfast, lunch, dinner, snacks, and beverages), and have the nutritionist identify your current nutrient intake. Clarify if you meet your needs for fiber, protein, vitamin D, B vitamins, vitamin K, fish oil, magnesium, probiotic, and zinc? Then work out a plan to ensure that you correct any obvious nutrient deficiencies, as much as possible with food, and use supplements to finalize your plan.

Similarly, meet yearly with an exercise physiologist at a gym and have them assess your strength, endurance, flexibility, and aerobic fitness. With that information in hand, have that fitness expert develop a plan to enhance your fitness over time. Of course, you’ll have to do the work, so make sure they make recommendations that are realistic for you and your schedule.

One of the keys to getting a good evaluation with your physician is to clarify up front, as you schedule your appointment with the receptionist, and as you begin speaking to your physician, that you want to optimize your health through healthy eating, essential nutrients, fitness, and proactive stress management, and that you are hoping that your physician can guide you on your way. That you would be willing to pay out of pocket for a few of the laboratory studies recommended if needed.

Please don’t sabotage your assessment by bringing a laundry list of complaints to your annual evaluation, such as headaches, rashes, or other health issues that are designed to be covered by a medical visit covered by your insurance. During my all-day assessment, I have the time to cover these type of concerns, but a regular doctor seeing 30+ people per day can’t do both, and dealing with aches and annoyances somehow takes priority over long-term health. If needed, make a separate appointment for any chronic medical problems, so that your physical can focus on your long-term health issues.

My hope is that addressing your key health issues (food, nutrients, fitness, stress management, and toxic avoidance) will help to transform your relationship with your physician for the better. This is your chance to step away from the traditional disease management focus, and instead, address your long-term health goals and aspirations.

I believe that you deserve the best of health. An annual health evaluation, with the proper attention, can help you to achieve your goals, and improve your quality of life for decades to come.

I wish you the best of health!

Steven Masley, MD, FAHA, FACN, FAAFP, CNS


If you’d like to have the best, most comprehensive physical evaluation of your life, to clarify how you are aging on the inside and what you could do to OutSmart Aging, then consider an Optimal Health Evaluation at the Masley Optimal Health Center, in St Petersburg, FL. Schedule by the end of May 2018 and receive $500 OFF your first full day evaluation, and get ready to transform your life for the better. Call Toll Free 844-300-2973, to schedule your appointment.