W hile studies have shown that physical exams aren’t absolutely necessary each year for most healthy men under age 40 and women under age 50, they’re worthwhile if your insurance carrier offers free or low-cost regular checkups.

Here’s how to make the most of your physical…

REVIEW YOUR HEALTH

The most important part of an annual checkup is the exchange of information between you and your doctor.

Before your appointment, send your doctor a memo. Fax or mail a one- or two-page outline of your recent health concerns. Be concise. Include any new symptoms... what time of day they occur... and how long they last, even if your condition is chronic and not new to your doctor. Also include in the memo...

Your family’s medical history. Don’t assume that your doctor remembers it or will review it before your appointment.

A list of all prescription and over-the-counter medications and supplements you’re taking -- or have taken in the past year. Your doctor needs to know what other doctors have prescribed. It’s also important that he/she have this information in case of a drug interaction.

Before your appointment, call your doctor’s assistant to request a chat with your doctor in his office to discuss your memo and other health issues either before or after your appointment.

A PHYSICAL EXAM CHECKLIST

Even though physical exams are standard, I find that most patients aren’t aware of the tests -- and don’t know the benchmarks of good health. Here’s a physical exam checklist to help you ask your physician better questions...

Blood pressure. Any reading over 140/90 is cause for concern.

Cholesterol. A blood test result that is over 200 mg/dl should lead to a more detailed evaluation of your LDL, HDL and triglyceride blood levels.

Electrocardiogram (EKG). Sensors placed on key parts of the body produce data about heart rhythm. Men should have an EKG done at age 40... women, age 50. Changes in EKG readings offer clues in the diagnosis of heart disease.

Fecal occult blood test checks for colorectal cancer. This test is recommended starting at age 50 -- or earlier if there is family history of the disease. Sigmoidoscopy should be considered after age 50 … and earlier if there is a family history.

Height/weight. Ask your doctor if he thinks you have a weight problem.

Skin-cancer screening exam is for men and women of all ages. The doctor examines every area of your body, including your scalp, genital area, bottoms of feet, fingers and toenails for suspicious lesions and/or changes in existing moles.

Urine analysis screens for diabetes and kidney problems.

Additional tests for women:

Pap smear. All women should have an annual Pap smear to check for cervical cancer.

Pelvis and breasts. Women should have a breast exam once or twice a year... and a pelvic exam once a year. Breasts should be examined in sitting and lying positions. Starting at age 50, women should have annual mammograms. Some experts recommend starting earlier -- especially if there’s a family history of breast cancer.

Reproductive organs are checked for changes in size and evidence of ovarian cysts and fibroid tumors. Women with family histories of ovarian cancer should request a CA-125 blood test and ultrasound of the ovaries.

Additional tests for men:

Testicles. These should be examined once a year for tumors. While they’re not common, they are deadly -- and can almost always be cured if detected early. Men should ask their doctors to show them how to do this exam themselves.

Prostate. Men over age 50 should have annual rectal exams to screen for prostate cancer -- especially if there is a family history of it. They should also have annual Prostate-Specific Antigen (PSA) blood tests.

Note: You may prefer to have the blood test before the rectal exam because the rectal exam can affect PSA levels. However, recent studies suggest that, in most cases, the rise in PSA is insignificant.

IMMUNIZATION

People over age 65 and those with chronic conditions such as cardiac disease, cancer or diabetes should have annual flu vaccinations. Older people and those with chronic illnesses who contract the flu are at higher risk of death from complications -- particularly pneumonia.

Younger adults who work with children -- such as teachers and day-care workers -- as well as health-care professionals should consider annual flu shots.

Important: I advise people over age 65 and those with chronic conditions to be vaccinated against pneumococcal pneumonia.

Every adult should have a tetanus booster every l0 years... and anyone who is sexually active with more than one sexual partner should be vaccinated against hepatitis B.

MULTIPLE APPOINTMENTS

The goal of an annual physical exam is to review your general health. If you have a major chronic problem, such as diabetes or cardiovascular disease, it is better to schedule a series of appointments.

AFTER THE EXAM

Ask your doctor...

Do you view me as being at an increased risk for any disease or health problems? If so, what kind of lifestyle changes should I make -- and can we set an early detection schedule?

If diagnosed with a condition: Do you feel the condition is under control? You and your doctor should be in agreement about testing and treatment strategies.