If you’ve let your annual physical go by the wayside for a year or more, you’re not alone.

More than one quarter of all Americans are not current with their health screenings and immunizations, a 2024 national survey reports.

That could be for a variety of reasons, including feeling healthy (and therefore feeling there couldn’t be anything amiss), fear of finding out bad news, financial concerns/lack of insurance or — the one Dr. Stewart Trimble, an internal medicine doctor with Novant Health Sewee Family Medicine in Mount Pleasant, South Carolina, hears most often — “It slipped my mind.”

But there are good reasons to make, and keep, annual physical appointments. We asked Trimble why it’s smart to check in with your primary care doctor every year, regardless of how healthy you feel.

Why should adults see their primary care doctor every year?

Not every disease presents with symptoms. Cancer, hypertension and diabetes don’t always show up in a dramatic, obvious way. I’ve had patients come in with wildly uncontrolled diabetes who had no idea they had developed the disease.

What can happen if you have diabetes and don’t know it?

If you have diabetes and don’t know, high blood sugar can damage your heart, kidneys, nerves and eyes without any obvious symptoms. Over time, this can lead to serious complications, from vision problems to slow-healing infections. That’s why regular checkups and simple blood tests are so important — catching it early makes a big difference.

In my early 30s, I had my blood pressure checked as part of my annual physical, and that was how I found out I had high blood pressure. I felt fine. Is this common?

Yes. A patient just like that was here recently for his annual physical. His pressure was sky-high, and he had no idea. He thought he'd always been strong and healthy. He had no symptoms. I started him on medicine immediately.

Another patient hadn’t been to a doctor in many years. He came for a physical when he turned 65 since Medicare covered the cost. His lab results showed he had diabetes. He’s very skeptical of doctors. I was concerned his skepticism might mean he didn’t trust his blood test results. But that wasn’t the case.

What do you say when you do encounter a patient who doesn’t trust their blood test results?

I explain what’s going on and discuss some potential consequences of leaving the condition untreated. I don’t demand compliance or give a lecture. I think of myself as a partner to my patients — not a drill sergeant.

If somebody hasn't had a physical in a very long time and is reluctant to make an appointment, what can they expect?

It’s important to get a physical as a young, healthy adult to establish a baseline when you're at your best. That way, you have some basis for comparison. If you and your doctor see any variation, any degradation, anything that's getting worse, you can address it. In America, I should add, our cholesterol will almost always get worse. A checkup will include:

• Health questions: There’s an intake process that involves a questionnaire with questions like: Do you smoke? What medical conditions do, or did, your parents have? I review that questionnaire with my patients at their physical. I’ll ask them follow-up questions, and I tell them they can ask me anything.
• Review of symptoms: We go over what we call “the review of systems” from head to toe. Do you get headaches? Do you have vision problems? Chest pain? Heart palpitations?
• Physical exam: Generally, the physical exam I do is brief. I can listen to and feel for all the vital organs, how they function. The patient is sitting and fully clothed.
• Blood test: At most offices, you’ll get blood drawn at your appointment. This checks for abnormal levels of substances in your blood that may indicate a health problem. You may also have had bloodwork done before your appointment so that you can discuss the results with your doctor.

If there’s anything abnormal in your blood test, you and your doctor will discuss those results, what they mean and the options you have to address them. They might include lifestyle modifications, such as diet and exercise as well as supplements and prescription medicines.

How long does an annual physical take from checking in at the front desk to checking out?

The total experience shouldn’t take more than an hour, unless you have a lot to talk about. And I always encourage people to talk about everything they want.

What are some questions patients should ask during their physical?

You should review every medication — prescription and over-the-counter — you take and discuss why each one is necessary. It’s always good to ask if you might be able to take less or even safely discontinue some of your medications if you have a heavy pill burden.

It’s a good idea to bring your medications with you. It’s not enough to know the names of the medicines you’re on. You need to know the dosage, too.

It's a good idea to ask:

• Given the conditions I've been diagnosed with, what are some diets that are friendly to this or that condition? What are some foods I should avoid?
• What exercise is safe for me to do?
• Am I current on all the vaccines I need?
• What can I do in my home environment to improve my health? That’s an important one. Doctors can’t know what a patient’s home is like. Is it filled with junk food? Is it moldy? Is the water clean? Are there any trip or fall hazards, like area rugs?

If there’s something that has come up since you last saw your doctor, please bring it up. Never be shy about mentioning anything, even if it seems insignificant. One symptom may not be all that much, but combine it with a few other minor symptoms, and there could be a unifying theory that explains them all. Any little thing could be a big thing, and we always try to rule out the worst-case scenario.

Why is it important tell our doctors about every over-the-counter vitamin and supplement we take?

Some vitamins and supplements can interact negatively with other common medicines. St. John's wort is the one we tend to think of first. It’s an herb that can be used to treat mild depression. It can also reduce the effectiveness of antidepressants, oral contraceptives, certain blood thinners, HIV drugs, even some cancer treatments.

Just because something is labeled “natural” and available without a prescription doesn’t mean everyone can take it safely. Herbal supplements aren’t just benign. Some of them can do real harm if mixed with other drugs.

Do you talk about mental health during an annual physical?

Absolutely. If your doctor doesn’t ask you first, bring it up.

A lot of people are reluctant to talk about their mental health struggles; they feel they’re supposed to be strong and tough. They may not want to admit they’re struggling with depression or having panic attacks. Primary care providers are very well equipped to at least start that conversation.

I would say that close to 70% of patients I see are struggling with anxiety or some other condition that’s stress-driven. It is very, very common.

Anything else people ought to know about annual physicals?

I want to reiterate that not making an appointment because you feel fine and therefore presume everything’s OK is a risk. It’s still a good idea to come in, talk to your doctor, have some blood tests done.

No one should be intimidated to see a doctor. “White coat syndrome” is a real thing; some people are nervous in the doctor’s office for a variety of valid reasons. But a physical is nothing to fear. Think of it as preventive maintenance. It’s great when a doctor’s visit confirms that you are as healthy as you feel. But when an appointment shows something of concern, it’s always better to know that early than to find out after the condition has progressed.