What a Real Annual Physical Should Cover (And Why Most Don't)
Most patients see their doctor once a year for an annual physical. It's the one "covered" visit under most insurance plans, and for many people, it's the only meaningful contact they'll have with a primary care doctor in a given year.
That makes the annual physical important. But are patients actually getting what they think they are?
What's Actually Covered Under "Covered"
Patients often assume that an annual physical is a standardized, comprehensive evaluation of their health. The truth is more complicated. What's "covered" under your insurance is a defined list of preventive services—generally a few specific screenings and labs based on broad population guidelines. It can vary from one insurance plan to another, and it usually doesn't leave much room for your individual concerns, history, or questions.
The visit itself is often shorter than people expect. Many annual physicals run 20 to 30 minutes, but the actual face-to-face time with the doctor is closer to 10 or 15. The intake questions are answered on a tablet or asked by a medical assistant. The doctor comes in for a brief exam and to order labs. And if something specific is bothering you—a knee that hurts, a new skin lesion, a question about a medication—you're often told that this is a physical, and you'll need to schedule another visit to address it.
It's not that doctors don't want to do better. Most of us would love to. But the system is built around volume and coding, not depth.
What a Real Annual Physical Should Look Like
So much of who you are as a patient is unique to you, because health is influenced by all of it. Your habits. Your work. Your culture. Your childhood influences. The family history that may or may not matter for you, specifically. Your stage of life. A thorough annual visit pulls all of that into focus.
In a well-designed annual visit, there's time to:
Sit down and actually talk. About sleep, stress, mood, relationships, sexual health, work, what's keeping you up at night, what your goals are. Not a clipboard with checkboxes, but a real conversation.
Walk through your family history in detail—not just "any cancer?" but who, what kind, what age, and what it might mean for your screening.
Cover preventive care that's tailored to you. An 18-year-old, a 40-year-old, and a 65-year-old don't need the same physical. Men and women don't either. A real annual visit accounts for who you are now and what you need at this stage of life.
Address what's actually bothering you. That skin tag, that knee pain, that new symptom—they don't get pushed to another appointment. They get looked at.
Order labs and screenings that make sense for you specifically, with the rationale explained, not a generic panel.
Have a real conversation about your future health goals—what you want for the next year, the next five years, the decades ahead—and what interventions are realistic and feasible for your life. Then a clear plan for how we'll measure and monitor progress along the way.
Plan a real follow-up after the labs come back—a sit-down review where the results are explained with context, not a five-second message that "everything looks fine" or, worse, the dreaded phone call: eat better and exercise more.
It is what an annual physical should be.
What Gets Missed in a Rushed Visit
When there isn't time, things slip through.
The perimenopausal symptoms a 43-year-old doesn't mention because no one asked. The HbA1c that's been creeping upward over three years but never flagged because no one looked at the trend. The blood pressure that read normal on the day of the visit but has been climbing across annual visits for five years. The family history of early heart disease that didn't come up because there wasn't time for that conversation. The sleep that's been off for six months but didn't make it into the ten minutes.
None of these are dramatic, single-day diagnoses. They're the quiet things that compound. And the whole point of an annual physical is to catch these early.
What You Can Ask For at Your Annual Physical
A few things worth asking for at any annual visit, ours or anyone else's:
Ask about age-appropriate screenings. What's recommended for someone your age, sex, and risk profile—and what's being ordered for you today?
Ask what labs are being done and why. A panel is more useful when you know what each test is looking for.
Mention any changes in your family history. A new cancer diagnosis in a parent or sibling, a sibling's heart attack—these can meaningfully change what screenings you should be getting.
Ask if you can schedule a follow-up to review your labs. Not a portal message—a conversation. Ask what each result means and what the plan is.
Get a copy of your results, digital or printed, and save them. Over time, your own records of blood pressure, weight, A1C, cholesterol, and other key numbers tell a far more useful story than any single visit's results.
Why I Built Anchor This Way
I want to spend real time with my patients at their annual physical. I want to go through every concern they brought in, not just the ones that fit into a standard preventive code. I want to look at the trends in their numbers. I want to walk through their labs with them, explaining what each result means and why I'm recommending what I'm recommending. I want to be able to address the skin tag and the knee pain and the sleep that's been off—in the same visit, because that's what an annual should be.
This is the kind of medicine I always wanted to practice, and the kind I believe patients deserve. Direct primary care is what finally made it possible. Without the constraints of insurance billing and short appointments, there's room to do the job properly—the way every doctor I trained with hoped to practice when they started.
An annual physical isn't supposed to be a checkbox. It's supposed to be the one visit a year where someone really looks at you, listens to you, and helps you plan what comes next.
If you're thinking about what your next annual physical could look like, I'd be glad to talk. Schedule a Meet & Greet to learn more about Anchor Primary Care.
