New Year's Resolutions: The Annual Exam and Why You Should Get One

Attention to health is life's greatest hindrance.
~Plato


Ah, the New Year.  This is the time of year when everyone looks at life anew, measuring and marking accomplishments of the year past and new goals for the year to come.  It is no surprise that they sell more exercise equipment and gym memberships at this time of year than any other!  We all want to start the new year on the right foot, and that means new year's resolutions across the board.

As a physician whose specialty revolves around taking care of only women, I am continually amazed at how much women accomplish on a daily basis.  Women are the backbones of their families, and they keep everyone on track, from making sure that kids get to appointments/school/practice on time to doing the family's shopping and getting dinner on the table to keeping the house in some semblance of order.  And the majority work outside of the home to boot!  Since becoming a mom myself, I am beginning to realize how women do all of this....they don't sleep much.  But they know that if they don't take care of things- things may very well not get done.

This is why I am not surprised when women tend to ignore their own health needs.  After all, there are only so many hours in a day, and most women will address the needs of their family members before their own.  Every person has to reach their own balance in life, and there are some things that women are going to sacrifice for their families.  That is just the reality of it.

The annual exam to your doctor should not be one of those things.  Why?  Because the only way that you are going to be around to keep your family running is if you take a moment to address your own health.  This doesn't have to be a long and drawn out affair- we are talking simple prevention!  When Benjamin Franklin said that an ounce of prevention is worth a pound of cure- he really was on to something.

The annual exam comes in different shapes and forms and can be done with a variety of doctors: family medicine doctors, internists and one near and dear to my heart- your gynecologist!  What does this involve, you ask?  Every speciality does things a little differently, but the principles are all the same.  Most exams involve a head to toe physical- the kind where they listen to your heart and press on your belly- in addition to some conversation about your lifestyle.

• What are your health habits?  Do you have good nutrition in your busy life?  Do you get out and get moving every once in a while?
• When was your last lipid screen?  This simple blood test can detect high cholesterol levels that could otherwise negatively impact your future health in a big way (we're talking early heart disease and stroke!).  Catch this early and you can make changes that can literally save your life.  It's a big deal.
• Are you up to date on immunizations?  Many people do not realize that simple, preventable diseases- like whooping cough- are making a comeback in the United States today.  This is because folks don't up to date on their immunizations.  Immunization is singlehandedly one of the best prevention techniques out there.  Other vaccines, such as the HPV vaccine, can actually help prevent some cervical cancers.
• Speaking of cervical cancer, when was your last Pap smear?  Most women get one annually, although this can be spaced out to every three years if you have had negative HPV testing.  HPV is a pesky little virus that causes big problems like cervical cancer.  The bad news?  Over 75% of the population has been exposed to some form of HPV.  The good news?  A pap smear can detect precancerous changes in your cervix- so get one!  Pap smears save lives.
• If you are over the age of 40, mammograms become a part of your prevention arsenal.  No one said they were pleasant, but newer technologies have made them less uncomfortable than they were previously, and mammograms can detect early breast cancers.  I will repeat:  mammograms detect breast cancer!  Why would you not want to detect breast cancer if you can help it?
• If you are over the age of 50, then a colonoscopy becomes a must.  I have had patients come up with really creative excuses not to get a colonoscopy.  Don't get creative- just get your colonoscopy done already.  The reasons are simple: colonoscopies detect colon cancer, and colon cancer kills people.  Enough said.  The bad news?  You have to clean out your colon beforehand and have a camera up your butt during the procedure. The good news?  They put you under for it and you won't remember a thing.  The best news?  You only have to have it done once every ten years- and it could very well save your life.      
• What is your family history?  Do you have a strong history of a certain illness that runs through your relations?  There is a genetic component to some diseases such as breast&ovarian cancers, colon cancers, early heart disease/stroke, etc.  The doctor at your annual exam will take the time to review this with you as well, and direct you accordingly.

I always tell my patients: there are a lot of things in life that you have no control over- like getting into a car accident for example.  As a physician, there are a lot of things that I don't have control over- I won't be able to prevent you from getting leukemia, or kidney failure, or brain cancer.  In medicine, we have the ability to prevent only a handful of conditions- that's it.  And those things are listed above.  Since these are the things that you do have some control over, exercise that control and take a minute to address your health this new year.

As women, we want to be there for our families- that is a top priority for so many of us.  And I can certainly appreciate how busy life gets- god only knows my own life is chaotic most days.  But think of the big picture.  How are you going to get little Johnny to soccer practice if you are recovering from surgery for an abnormal Pap smear?  It will definitely be harder to get dinner on the table if you are battling a breast cancer that a simple mammogram could have picked up.  In the grand scheme of things, the complex life that you lead (not to mention all of the lives that revolve around you) will run even more smoothly if you are a happy, healthy captain at the helm.

So go ahead and put yourself on the books for your annual exam- and then begin the task of convincing your significant other to go as well (we all know that is the harder thing to do!).  As the caretaker of your family, you owe it to yourself to be taken care of as well.
Best wishes for a happy holiday and a healthy new year ahead!
-Dr. Jahedi

Welcome to Advanced Gynecology!

Advanced Gynecology is my venture into private practice- an attempt to deliver care the way I believe that care should be given.  The relationship between a doctor and patient is a sacred one, and one that has been pushed to the wayside in a current healthcare system that is flawed in so many ways.

When I went to medical school to become a doctor, I knew that I wanted to take care of people and to alleviate pain.  It took a decade of study to accomplish the education necessary to do this, and I spent my twenties at the library and in the hospital.  As it turned out- that was the easy part!  No one really schools you about the sheer administrative burden involved with being a physician these days.

As I learned after I joined a large group practice after residency, your success in private practice is almost entirely dependent on seeing a lot of patients during your office hours.  Physician schedules are packed to the hilt in an attempt to increase revenues in a healthcare climate that is paying doctors less, and (ironically enough) in an era of rising malpractice costs and overhead.  The only way most docs can keep afloat is to see a lot of patients and hence increase their reimbursements from insurance companies.

It is a terrible system, because most doctors cannot legitimately address anyone's concerns in the 10 minutes that they are allotted to see a patient.  I know I couldn't.  As a result my 10 minutes with a patient would turn into 20 minutes, and my entire day would end up backlogged- all in an attempt to provide good care!  Patients in turn end up just as frustrated, because they spend more time in the waiting room than with the doctor, and in today's economy, their time is just as valuable.

So what is the solution?  More realistically, what kind of control do I have over trying to find a solution? Trying to change the rising costs of malpractice is a huge undertaking and a battle that doctors have been fighting for years.  I'm not going to be able to fix that.  Trying to increase the amount that insurance companies reimburse doctors is also virtually impossible, as these are large corporations whose primary goal is to make a profit, and they will decrease reimbursements to doctors as much they can for as long as they can.  I'm not going to be able to fix that either.

The only sort of control I have as a physician is to try to decrease my overhead.  Running a small business costs money (there are a lot of my patients who know that firsthand!) and costs can add up quickly.  My goal- and venture- with Advanced Gynecology is to use as much technology as I can to decrease my office costs, which will in turn allow me to see less patients a day, which will let me take better care of them the way I went to medical school to do.  Simple, right?

Welcome to the practice.