What actually happens at an annual physical

The annual physical is the most-scheduled visit in primary care and one of the most poorly explained. Patients show up unsure what to expect and clinicians often do not walk through what is happening in real time. This paper walks through every section of a typical physical at Station Medical so you arrive prepared and leave knowing why each part mattered.

Before you arrive

You will be asked to update your history before the visit. This includes:

• Current medications, supplements, and over-the-counter products.
• Major events since your last visit (hospitalizations, new diagnoses, surgeries).
• Family history changes (a parent or sibling with a new diagnosis is relevant).
• Any specific concerns you want to raise.

Fast for 8 to 12 hours before the appointment if labs include a lipid panel or fasting glucose. Water is fine. Take your usual medications unless we specifically tell you to hold one.

Vitals

The visit starts with a quick set of measurements:

• Blood pressure. We check it after you have been seated for a few minutes. A single elevated reading does not equal hypertension. We may recheck or ask you to send home readings.
• Heart rate and rhythm. Resting heart rate gives a window into cardiovascular conditioning.
• Weight, height, BMI. BMI is a screening number, not a diagnosis. We use it as a starting point.
• Oxygen saturation. A quick pulse oximetry check.
• Temperature. Only if you are feeling unwell or if there is a reason to suspect infection.

The history

We spend real time on the history. This is the most important part of the visit. We will ask about:

• Sleep. Quality, quantity, snoring, daytime fatigue.
• Diet. Not in a judgmental way, in a “what does a typical day look like” way.
• Activity. What you do most days. Strength training matters as much as cardio.
• Mood. Brief screens for depression and anxiety are standard.
• Substance use. Honest answers help us help you. We are not here to lecture.
• Sexual health. Routine in adult primary care. Skip what you do not want to discuss.

Bring your questions written down. The five-minute mental list always shrinks when you are sitting on the exam table.

The physical exam

A typical exam covers:

• Head, eyes, ears, nose, throat. Quick look for thyroid enlargement, lymph nodes, or oral health issues.
• Heart and lungs. Auscultation for murmurs, abnormal rhythms, breath sounds.
• Abdomen. Palpation for tenderness, enlarged organs, or masses.
• Skin. A quick scan for suspicious lesions. Patients with a personal or family history of skin cancer get a more thorough check or a referral to dermatology.
• Extremities. Pulses, swelling, range of motion.
• Neurologic. Reflexes, sensation, gait if relevant.

For specific age groups and risk factors, additional exam components apply (testicular exam, breast exam, pelvic exam). These are discussed first and are always optional.

Labs

A standard adult panel usually includes:

• Complete blood count (CBC). Looks at red cells, white cells, platelets.
• Comprehensive metabolic panel (CMP). Kidney function, liver function, electrolytes, glucose.
• Lipid panel. Total cholesterol, LDL, HDL, triglycerides.
• Hemoglobin A1c. Three-month average glucose. Screens for prediabetes and diabetes.
• Thyroid stimulating hormone (TSH). Screens for thyroid dysfunction.
• Vitamin D. Often added in our population.

We add tests based on your history and risk factors. Common additions include vitamin B12, ferritin (iron stores), testosterone for men over 40 with symptoms, and hs-CRP if cardiovascular risk needs a closer look.

Screening

Age and risk-based screening recommendations come from the US Preventive Services Task Force (USPSTF, 2024). Common items we discuss:

• Colorectal cancer screening starting at age 45.
• Mammography for women, timing based on personal and family history.
• Cervical cancer screening per current guidelines.
• Lung cancer screening for adults with a significant smoking history.
• Bone density at appropriate ages.
• Abdominal aortic aneurysm screening for men 65 to 75 with a history of smoking.

We do not order screening just because. We talk through why each one is on the table and what the next step is if something turns up.

Vaccines

We review your immunization record and recommend what is due. The most common adult vaccines are influenza annually, COVID per current CDC guidance, Tdap booster every 10 years, shingles for adults 50 and up, and pneumococcal vaccines for adults 65 and up or earlier with risk factors (CDC adult schedule, 2026).

What happens after

You leave with a plan. That plan includes:

• A summary of what we discussed.
• A list of any prescriptions started, refilled, or changed.
• The labs that were ordered and where to get them drawn.
• A follow-up date if needed.

You receive your lab results within a few days, with a note from us explaining anything that needs attention.

The next step

If it has been more than a year since your last physical, schedule one. Even if everything feels fine, the annual is where we catch the things that have not started bothering you yet. It is also the visit that builds the relationship that makes every other visit easier.