As a senior, problems can come up quickly. Some you might not even fully realize yet. I would do bloodwork twice a year.

I am in FL, but still see my Drs in AL (sometimes a video appt, and lab orders sent to me). Trying to find a family medicine practice in our area taking new patients and actually answer the phone and/or return calls, which has been impossible. When I see my Endo in March, I am also seeing the cardiologist in that group - first time to see a cardio doc. DH started seeing him two years ago and I've been meaning to make an appt. I would also do a sonogram.

I think being proactive is a good idea.

It's up to you...your body. But there are no side effects from a sonogram so there's that. If she was recommending something with dye or radiation, probably not.

Do you know what she'd be looking for, what she would be checking, and whether or not you're at risk for it?

Is there any reason not to do the sonogram? If insurance pays for it, I’d go ahead, although it does seem overly cautious to me. Did the doctor give you any reason for the frequency? I have my eyes checked twice yearly due to a family history of glaucoma.

Ive had several abdominal ultrasounds but only because there was reason for concern . All’s fine.

But to answer your question, my doctor does not prescribe sonograms twice a year, not even once unless there is a reason.

Sorry for any confusion. Doctor was not suggesting sonograms twice a year. Just blood work.

My question was if anyone was checked just by a stethoscope.

Again, I'm fine with sonogram. Test ordered due to my group.

I am all for being proactive, but I didn't want to over tax the system. I'm grateful for the medical coverage and didn't want to do more than necessary.

Twice a year seems to be the standard, especially if you have any medications you take regularly. Doing certain screening tests is also standard as we age. Most are a one time screening/baseline taking and not done routinely each visit or each year.

There has been a fair amount of controversy over the value of physicals, period. If you are healthy and do not have a history or family illness, Dr. Andrew Weil, who I respect and follow, says every 5 years!

That said, if it is non invasive and doesn't cost money I suppose why not?

It always costs someone, even if it isn't directly costing the person getting the test . When non indicated testing is ordered, our premiums are going to reflect that.

My husband had a routine carotid artery study about 10 years ago. We weren't on Medicare then. As I remember, it had something to with the fact that he had been a smoker. (Even though he quit about 45 years ago.)

Other than my thyroid testing, my lab is done once a year.

He or she may have heard a slight bruit when listening to your carotids and that may be the reason for ordering a sonogram. Did the doc mention an abdominal aortic aneurysm? They are also evaluated initially with a sonogram. Some doctors do not explain next steps very clearly . If you have a question why you are getting a test, call the office and ask!

Other than what is standard preventative assessment, I would not want things like sonograms unless there was a stated reason. I've seen my parents go through lots of unnecessary testing that sometimes resulted in false scares or recommendations for treatments that upon a second opinion were not needed. Not to mention the anxiety involved. ETA: my parents also always had excellent medical insurance that covered everything. I often wondered if this led to a lot of the unnecessary assessments.

Thankfully we are both healthy as a horse and I don't consider us seniors, even though I guess we are? No, I'll go with middle aged LOL. We try to have a yearly physical, although I will admit we are sometimes behind. I see no need (for us) to have twice yearly physicals unless there were some reason. I do still see a gyno and my allergist yearly. One thing I would suggest is using an internist vs a "family physician". Years ago when I was having gallbladder issues, I had the most wonderful gi doctor who recommended I switch to an internist. I do feel they are more indepth, etc. than a family doc. Sadly, ours moved out-of-town a few years ago. We can see others in the group and there is a PA there I like, but we are still looking for a new internist. So far, cardiac testing, sonograms, etc. have not been suggested for either of us. Did you ask why your doctor wants to do the sonogram? I do believe in being proactive, but not unnecessary testing.

It always costs someone, even if it isn't directly costing the person getting the test

I didn't want to be a scold, but this is true. As i sometimes admonish my kids, even if something is "free" it may still be, as I put it, "a waste of the world's resources."

I had a congenitial heart defect unbeknownst to me that caused me to stroke in my 40s it has been fixed but I have also an atrial aneurysm so now i have echo’s yearly to have my atrial and aorta checked for a enlarging aneurysms. I think a base line sonogram of the heart is more important than mammograms in women under fifty with no BC history. Many more women die of heart disease than breast or colon cancers.

You are right @mtnrdredux_gw and I feel that unnecessary testing/medications (costs) may contribute to the high price of medical care.

Good point @roarah

That said, if it is non invasive and doesn't cost money I suppose why not?

My issue is that tests can lead to more tests and overtreatment for routine and incidental findings. Seek and ye shall find.

Plus, adding scans without explaining them reeks of padding the bill. Maybe your doctor is not doing that, but I would wonder and it would certainly undermine any trust I felt in the relationship.

I have never been one to go for the yearly physical, much the less more often. Lots of research supports this stance, as Mtn. said.

Interesting discussion. It's making me stop and rethink scheduling a mammogram that my GYN recommended because it had been just over a year since my last one. I have no personal or family history of breast cancer yet they are recommending one every year. Does that seem excessive?

I generally have a mammogram every 18 months rather than every year. But no family history doesn't mean anything; the NIH says that "85 percent of women with breast cancer have no direct family history of the disease."

ETA: "The United States Preventive Services Task Force (USPSTF) recommends that women who are 50 to 74 years old and are at average risk for breast cancer get a mammogram every two years."

One thing that the general public doesn't realize is that doctors get "graded" on doing certain things. This effects reimbursement rates. The insurance companies are trying to reward doctors for doing the right thing in the treatment of their patients. For instance, do their diabetic patients get regular A1c's, yearly eye exams, P/C ratios yearly, etc. This is checked to try to prevent complications down the road.

As mentioned above, perhaps a screening tool recommended the US for you. I had a bone density test because Medicare recommended one. I had always laughed it off because in my words "I'm not the picture of osteoporosis" at 6 ft tall and heavier. Well guess what? I do have osteoporosis and two spinal fractures. This changes things for me now.

So long way around, get the US. If it shows nothing, you are good to go. If it does show something, you maybe heading off future problems.

Kudos for thinking about the necessity of the procedure and the ultimate insurance cost - perhaps not personally to you but ultimately to you and all of us with increased medical costs.

My father had blockage on both of his carotids due to lifelong smoking and had successful surgery to improve blood flow. It was detected during a regular clinical exam.

My internist is aware of my father's history and has never suggested a sonogram. I have blood labs and an office visit twice a year since I take atorvastatin. He always checks both carotids and listens for a bruit (a swooshing sound) as part of his exam. Other than that I am relatively healthy. I asked DH who was a medical oncologist/hematologist and he said I didn't need one.

I would ask your physician exactly why a sonogram is recommended. Does your physician recommend them for all patients? everyone over a certain age? was something detected on the exam?

As for mammograms - Bookwoman is right. More women without a family history of breast cancer are diagnosed with the disease. Hence the importance of mammos.

Eld, as you might know, seniors can have different needs.

I would get those USs, particularly if you have not had them before.

I have pretty much been like some here, conserving resources, but several times, I have much regretted it as things turned out.

You never know.

A month ago, there was a news item about a well regarded 49 year old sports reporter whose wife is a physician who frequently gave us TV updates on the Covid-19 pandemic. While covering the World Cup in Quatar, Grant Wahl died very unexpectedly of a ruptured aortic aneurysm.

https://www.cnn.com/2022/12/14/us/grant-wahl-cause-death/index.html

Not common, but not unheard of. Some decades ago, there was a traditional folk musician who succumbed to a dissecting aortic aneurysm. He was also young and had gone to the hospital with abdominal pain. In those days (guessing 1990s) there was absolutely nothing they could do for him other than offer comfort meaures fow the days efore he died (in hospital). That situation had a truly tragic outcome, as it turned out, because someone else became a sad casualty.

Why not just get a quick baseline scan? It isn’t that costly an exam.

Petalique, I did. But was surprised that my sisters doctor screened for issues right in the office with her stethoscope.

Eileen- I may be the wrong person to comment, but I say to get that yearly mammogram regardless of family history. At 49, at a yearly screening, the radiologist saw calcifications he didn’t like. Asked me to follow-up 6 months later. Sure enough, calcifications had increased, leading to a biopsy and a diagnosis of breast cancer. Good news is it was caught very early & I was able to avoid chemotherapy because of this. A year earlier, my screening showed nothing of concern.
My point is that although every 2 years may be ‘good enough’ for many- in that extra period of time, patients can go from very early, non-invasive cancer to invasive cancer. Often very different treatment plans, although not prognoses.

I go for the yearly physical and blood work. I am in bascially good health. I do see an eye dr 4 times a year and this is my anecdotal way of saying, that maybe it's not a bad idea to get checkups.

I used to get an eye exam every year ( maybe yearly or every 18 months)- I had no issues and since having had lasik about 25 years ago, had no vision issues.

Then covid hit, and remember back when the medical offices started to open up for non emergencies? Well I was thrilled to have something to do- an excursion - and realizeing it was now over 18 monhts I scheduled an eye exam. To my amazement, I had ocular hypertension. It's easily treatable, but left untreated could lead to glaucoma. I kept asking if there was anything that I could have been aware of and was told that there is no way I would know that until maybe it had progressed way too long.

Fortunately, it seems I have no other damage ( no nerve, no field vision) and we just monitor every 3 months... so this is one example where I;m glad I went for a check up. I was totally expecting to hear "see you next year"...

Also regarding family history, at least in my family the grandparent generation died so young, and with such poor medical care that who knows what they actually had. I am not aware of any cancer in the family but I often think, who knows?

With respect to mammograms, get them yearly. To paraphrase a leading oncologist on this subject, there no test is more inconvenient than having undetected cancer.

My mother had breast cancer at age 75, which is the age I am now. No previous family history. I go yearly, even tho her age doesn't constitute a 'family history' for me, per guidelines.

We die at the same average age of breast cancer in the us as in england where most women around 50 only just had their first ever mammogram. our mammogram scheme does not lessen our likely hood of dying from breast cancer ironically. we live knowing we have it longer or maybe we treat early cells that would have self resolved without intervention because our country is not ahead in terms of dying from BC than others that do not aggressively search for it which is why yearly mamms are not universally recommended by many international physician groups. This does not apply to family history or high risk groups

quote from an interesting study.” Deaths from breast cancer have decreased as mammography has increased, but differences in the decreases across geographic areas suggest overdiagnosis. Autier et al. (2010) find that breast cancer mortality for women under age 50 fell from 1989 to 2006 in all 30 European countries that they examine, but they note that the greatest reductions occurred in countries where screening was less common. “

Roarah- that’s definitely true and that’s why I included that treatment may change based on early diagnosis but not necessarily prognosis.

Similar arguments can be made for genetic testing. You find out you have a mutation, now what can you or do you do about it? I think we all have to figure out our own level of comfort with these things.

One thing to note is that early detection can lead to longer lives, living with cancer as a chronic / recurring illness. Yes, the death rate in the end from breast cancer may be comparable in groups with different screening protocols, but I personally know women who have lived with a BC diagnosis for twenty years. It was caught early, treated, went into remission, recurred, treated, and so on. They were able to see their children through the high school years, in some cases see them married with children. Every woman I know would rather have an earlier diagnosis and a longer life, even if they eventually succumb to breast cancer.

Over screening is not harmless at all. It skews stats, introduces unnessary surgeries, worry and carcinogenic radiation and treatments. Not even mentioning the cost analysis of risk vs benefits. It is why countries with universal health care opted out of American gold standards and yet many have lower cancer mortality rates than us. Americans have been brainwashed to believe we have control over cancer mortality by screening and living with it longer and that is not at all proven. Infact evidence actually shows otherwise. It is not incidental that our nation’s most followed mammogram schedule is promoted by an organization that profits greatly from them, the American college of radiology .

England does screening better than usa and far less frequently https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6525304/

Harm of over screening is a big deal

https://www.statnews.com/2018/01/01/cancer-screening-misled-risk-factors/

There is nothing as harmful, or as costly, or as inconvenient, as cancer.

well actually heart disease is far more harmful, deadly and costly statistically to all cancers combined and we underscreen that because lobbyist brainwash us to fear the c word more …

Although I still wouldn’t qualify, I wish I had been screened (LDCT) for lung cancer before it had the chance to spread.

Yesterday was Frameless Stereotactic Radiosurgery day to zap a new spot found on my brain. Followup MRI is the end of March, it takes awhile for the radiation to work.

Yes, I smoked cigarettes back in the 19 hundreds. Casual smoker, never near a pack a day.

Eligibility for LDCT;

”The USPSTF recommends annual screening for lung cancer with low-dose computed tomography (LDCT) in adults aged 50 to 80 years who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years.”

I have no family history of colon or breast cancer but since before i was fifty i could have free screenings for those. Yet with a paternal family history of melanoma I pay yearly out of pocket hundreds of dollars for a dermatologist’s preventative screen. Why!? Because lobbyist ( for radiologists and GI specialists ) placated to women ‘s fears by demanding that we all need high screening. Our system is wrong in so many ways :(

Maddy you are continually in my thoughts.?

Most insurances pay for an annual wellness visit, which should include a skin check. Some policies pay all or part of a skin check by a dermatologist. However, according to the CDC, "The U.S. Preventive Services Task Force (USPSTF) has concluded there is not enough evidence to recommend for or against routine screening (total body examination by a doctor) to find skin cancers early." I agree that skin checks should be included in all insurances. The solution, however, is not to replace some types of screenings with others, but to include them ALL in all healthcare policies.

I fear cancer, not because some lobbyist has brainwashed me, but rather because I personally lost my mother, MIL and a very close friend in the past 5 years to cancer.
All would have been deemed ‘the picture of health’ but none reached the US life expectancy.

Where you stand often depends upon where you sit.

Prepmom i prefaced the need for screening with a family history but we only screen some cancers and not others independant of family history. Other countries do not screen all with mammograms or colonoscopy they go by particular family history only and their survival rates surpass ours. It is over screening certain cancers while underscreening people with family histories of other diseases i find harmful economically and they have no proven benefits to improved mortality.

Rorah, you're talking about populations---groups---cohorts. The fact that screening may not statistically improve mortality for a large group is meaningless to the person whose cancer is diagnosed early and cured from a screening.

Many task forces both nationally and internationally say our use of mammograms are not proven to improve survival any more than skin checks. Our country mandates so many “popular” screenings because the industries that profit by the testing are allowed to lobby for it. our gold standards are based only on how much gold they can make. All other countries independently use data and facts collected by unbiased professionals to support their choices rather than might and money. Our screening recommendations are lobby based and political not anything to do with result based rational. We cure less breast cancer with our early screening than the uk, with out using aggressive screenings, do. Same with colonoscopy recommendations. read my link above. Emotions and money rule our medical screening not science. .

edited to add, our preventive schemes are a big reason our country will likely never offer universal health care. Insurance companies know this, drug and testing industries know this and politicians know this. universal health care can not afford to sustain screening with unproven benefits and our American mentality erroneously believes they are needed by all to save lives when that is proven to be false.

I agree, Roarah, but as an individual, putting aside for now the issue of wastefulness, it would be hard to argue against getting all the testing available as soon and as often as it is available, even if it has a low statistical probability of being useful. (Assuming this process did not cause you to be unduly obsessed and did not cause you seek unnecessary treatments --- ie assuming you are an educated consumer of the information produced.)

Of course, policymakers cannot and should no put aside the issue of wastefulnesss, as we have finite resources. But a given individual may have a different risk/reward tradeoff.

I am not arguing for no screening but rather for better screening recommendations based on data not money and emotions. i am advocating to follow a more science based individualized course which would be universally paid for, similar to the rest of the wealthy world.

I think that this is a fantastic discussion and only emphasizes how complex modern healthcare and the distribution of limited resources can be.

I agree that your annual (or how often you choose) should include a skin exam. Mine does. i have had basal cell carcinoma. These exams are covered by our insurance (minus a 10 or 20% copay depending on what dr i choose). An annual physical is fully covered (no co-pay).

ETA: To clarify, the exams where I have a copay are exams separate from my annual physical; either with my internist or dermatologist.

I always have a high deductible plan i pay nothing for wellness checks, paps, mammograms or screening colonscopies. I pay full price for dermatology skin checks, heart screening, neurologist, hematologist ordered blood screening( I have a genetic blood disorder) unless i have hit our deductible. I need the later screening tests far more than the covered screenings to stay alive and am lucky that hitting our 12k deductible does not break us yearly because my family has hit it every year for the last eight years.

Meanwhile, people in countries with less covered frequently unneccessary screening tests, get what they immediately medically need to live covered fully and get the screenings when needed too. the cost of our country’s prioritizing frequent and early screening with unproven benefits makes many people’s immediate medical needs unaffordable and that is only one large and possibly deadly harm of over screening.

It is naive to think that without a universal healthcare mandate any money saved by eliminating certain recommended or allowable cancer screenings would be shifted to cover other types of screenings on an as needed. basis. Even with a comprehensive change in our system that would cover everyone, a menu of screenings available based on the particular metrics of each person’s health history seems very far into the future. it could be done, obviously, but even the ”best” electronic medical records systems never seem to he able to eliminate old prescriptions from your digital chart regardless of how many times a nurse or doctor has done what is known as a medication reconciliation. I have zero faith in the ability or resolve of our piecemeal system to tailor preventive care recommendations, ever.

I fervently believe we should have universal healthcare in the U.S. I also believe it could be less costly than it is now, but because of many aspects of our national culture of it never will be.

We have this "weird" heath insurance that's very affordable! $650 a month for 2 of us. I'd always wondered if it would actually pay for anything out of the ordinary if we needed it...other than the annual woman check ups I get. It's "sharing" insurance. It says right in the paperwork it's NOT health insurance. Yet....last month I had a pelvic sonogram and I only paid $20 for the whole thing! It did pay!

If it's free tests....noninvasive...I'd do them.