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Time for a regular checkup? Here’s what doctors say you should ask about

The Dose21:09I haven’t had my regular checkup since before the pandemic. What should I ask my doctor?

If you haven’t been in to see your family doctor in the last two years, now may be the time to do it. So if I haven’t had my regular checkup since before the pandemic, what should I ask my doctor? We find out from Dr. Peter Lin, a Toronto-based family doctor and a director at the Canadian Heart Research Centre. 21:09

The pandemic interrupted routines for health, work and family – including regular checkups.

So if you haven’t been to see your family doctor since before March 2020, now may be the time. 

“There’s a lot of diseases still going on,” Dr. Peter Lin, a Toronto-based family doctor and a director at the Canadian Heart Research Centre, told CBC podcast The Dose.

“If you have diabetes, high blood pressure, all of those things need some fine-tuning.”

Those who have a chronic illness or new pain should see their health-care provider right away, he said.

And if you’re overdue for an age-related cancer screening test, like a Pap smear, colonoscopy or a mammogram, get in touch with your family doctor.

If you’re unsure whether you need a checkup, several physicians told The Dose about what to consider before making an appointment. 

Who should book an appointment?

Contrary to its name, an annual checkup isn’t something most people need every year, said Dr. Tara Kiran, a family physician at St. Michael’s Hospital.

“That’s a little bit of a misnomer.”

Instead, most practitioners and their staff look at several factors before seeing someone. 

“What we do is really try and target preventive care based on people’s health history and their age, sex and the [medical] history of their family,” said Kiran, who is also the Fidani Chair for improvement and innovation at University of Toronto’s department of family and community medicine.

time for a regular checkup heres what doctors say you should ask about
Dr. Tara Kiran says not everyone needs a yearly physical, especially those who are young, healthy and don’t have physical or mental health concerns. (Ed Middleton/CBC)

Staff also triage patients based on who is closest to the “cliff edge,” Lin said. 

“If you have a pain, a lump or anything like that, let’s get those things checked out now. Those are the things that we want to see right away.”

Patients without any complaints can be moved to a lower priority. 

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Dr. Peter Lin is a family doctor and frequent contributor to CBC. He says that patients should catalogue their symptoms before getting to a checkup. (Samantha Lui/CBC)

If you do have an issue, create a list of symptoms before you get to your doctor’s office, because that can help narrow down areas to test or examine, Lin said.

And if it’s your first visit, he said, it’s useful for patients to write down their family medical history.

Cancer screening

The pandemic also delayed access to cancer screening in many provinces.

Screening stopped in mid-March 2020 across most of the country, with programs restarting at limited capacity a few months later, according to the Canadian Cancer Society.

What that means is that there are a lot of people due – or overdue – for regular screening, a critical tool in catching cancer early.

“We want to capture cancers at a time that they’re small and at a time that we could actually use the word ‘cure,'” said Dr. Iris Gorfinkel, a family doctor, vaccine researcher, and a health contributor with CBC News.

“That’s why screening is so important.”

In Canada, criteria for cancer screening is based on a person’s age, lifestyle and family medical history. 

If you think you’re among those past due for routine screening, Gorfinkel, Lin and Kiran suggest calling your primary care provider – many can perform a Pap smear in their office or provide a referral for other tests.

WATCH | How the pandemic delayed routine skin cancer screening:

time for a regular checkup heres what doctors say you should ask about 2

Concerns about missed skin cancer screening during pandemic

5 months ago

Duration 2:03

Doctors are concerned some Canadians missed opportunities for skin cancer screening during the pandemic because they didn’t make in-person visits to their doctors that could’ve caught illnesses when they are more treatable. 2:03

Women aged 25-50 who are sexually active should get a Pap test at least once every three years, Kiran said, and anyone sexually active should routinely get tested for sexually transmitted infections.

Checking up on mental health

When it comes to mental health, the pandemic’s effects have been wide-ranging and some people may need medical help.

Kiran said warning signs include eating more, a decrease in exercise or an uptick in alcohol or cannabis habits. 

“Your family doctor might be able to provide you with tips, some very concrete strategies and maybe even medications to help.”

Another issue family doctors are seeing is long COVID, a condition that typically emerges within three months of having a COVID-19 infection – with symptoms lasting at least two months. 

Kiran recommends that people reach out to their physician if they have symptoms of long COVID, which range from shortness of breath, fatigue, chronic pain and cognitive difficulties, more than a month after getting the virus.

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Family doctors can also offer help for those whose mental health has worsened during the pandemic. (David Donnelly/Radio-Canada)

Routine vaccinations

The pandemic also saw many doctor appointments get cancelled for children – and some may be behind on routine vaccinations. 

“Those are vaccines that are traditionally given in schools, and they were actually paused during the pandemic,” Kiran said. “Now we’re trying to play catch-up.”

As the health-care system navigates the ongoing pandemic, and the delays created by it, not every Canadian will get an immediate appointment with their family doctor.

“We are trying to do the best job we can in terms of triaging in terms of who it is that we really need to see and see more urgently,” Kiran said, adding that younger, healthier people may have to wait.

Lin and Kiran said there are some tools people can use while they wait for an appointment.

For mental health concerns, Kiran refers patients to Wellness Together Canada’s website or Anxiety Canada’s online resources.

For people with hypertension, Lin said blood pressure monitors are accessible again so people can monitor themselves and look for any trends to flag to their doctor. 

And for teens behind on routine vaccines, immunization clinics for adolescents are happening at some public health units across the country.

Produced and written by Stephanie Dubois

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