Wellwoman routine physical with Walk-in Clinic

Monday, September 4, 2017

There are many difference to the health care system in the USA versus the UK. While I can list the positives and negatives of each, I don't think one is necessarily better than the other. Perhaps I am a bit jaded because I am still trying to figure out how the National Health Service (NHS) works and have had much more experience in how the US system works because I lived there for over 30 years.  I can say in both countries, I have received treatment for my ongoing skin allergies with success, have been successful in not developing another DVT (blood clot), and when I broke my toe in the UK, I didn't have to pay one cent for treatment (aside from the taxi).  In my opinion though, the NHS doesn't offer much preventative care, such as regular physicals or blood work once you turn a certain age.  This is probably due to the increasing demand on a system that is not staffed or funded adequately for the growing (both in sheer number and average age) population of the UK.

For those readers who do not live in the UK, when you book to see a GP (general practitioner aka your doctor) in the UK, the appointment is limited to 10-15 minutes, during which the doctor has to build rapport, listen to your concerns, perform an assessment, create a diagnosis, prescribe a treatment plan, and capture all data in the computer system required by the government.  You can only raise one concern at a time due to the short time frame.  Appointments in the USA don't offer much more time either.  You can invest (see the word choice I used there?) in private health insurance in the UK, which offers shorter waiting times for diagnosis and treatment.  Large employers may even provide this for you as a benefit.  So far, despite all of my pre-existing conditions, I have been able to receive the care I need courtesy of the NHS.

Waiting area

Needless to say, I was really excited when the Walk-In Clinic approached me to receive a complimentary Wellwoman medical examination.  The service is with a private GP and allows for a 90 minute meeting during which there is a head-to-toe review.  The City Clinic is in central London near the base of the Gherkin.  I was welcomed by a receptionist who gave me some forms to fill out about my eating/drinking habits and medical history, which I then reviewed with my GP, Dr. Juhasz.

Can I just say how nice it was to not be rushed through an appointment?  With 90 minutes, we could chat at lesiure about anything in my paperwork that concerned her (over-committing myself was identified as a possible problem).  She took notes on my form rather than staring at a computer screen the entire time, making me feel like we had a connection on a personal level and that she was listening to what I had to say.  It was her preference to go through the paperwork first while I was still dressed and then start the physical exam later (for which I put on an exam gown due to the ECG and breast exam).

Exam room

The Wellwoman examination includes the following:

•    Lifestyle assessment
•    Overall examination including BMI calculation, height, weight, fat content, girth and chest inspiration and expiration
•    Examination of the cardiovascular system including heart sounds and blood pressure
•    Examination of the respiratory system including peak flow testing
•    Examination of the musculoskeletal system – range of movement, restriction, tenderness
•    Examination of the neurological system – reflexes, sensation, power
•    Gynaecological / breast examination
•    Resting electrocardiogram for women over 45 or where clinically indicated
•    Urinalysis for 8 elements

Along with a full blood profile which includes:

•    Haematology (blood count, platelets, red blood cells etc;  white blood cells and ESR which are inflammatory markers)
•    Liver function screen
•    Kidney function screen
•    Serum iron
•    Calcium levels
•    Full lipid profile including HDL, LDL and total cholesterol, triglycerides
•    Glucose level
•    Thyroid function screen
•    Vitamin D

There are other tests you can add on depending on your needs.  I opted to add a thyroid test and a long-term blood glucose test to see if there is a medical reason for why I am always tired (not just from over-committing) and to see if all the cookies I consume are negatively affecting my health (my co-workers think I must be pre-diabetic).  Together, Dr. Juhasz and I decided not to have an internal gynaecological examine as I am up-to-date with my pap smears.  This is available though for those who are interested.

The highlights of my results are below. Overall, I received a clean bill of health.  Dr. Juhasz explained that the BMI and percent body fat are not always the most reliable measures of health due to available testing methods that are convenient and cost-effective.  I usually explain this to my new clients so it was a bit funny being on the receiving end of this advice.

As I mentioned above, we also did an ECG, which came out as normal.  I wasn't very good at blowing in the tube for my lung function tests (spirometry) though.

In the past, my cholesterol has been excellent.  I was curious to see if two years of eating meat after being a vegetarian for so long would have affected my results.  They are still pretty awesome.

Test                                                                 Result                                          Ideal Range

My bloodwork results were in the advisable range with the exception of Vitamin D, which was on the cusp of being low.  This is completely normal for folks living in the UK because there isn't much sunshine.  I was advised to start taking a multi-vitamin to help top up my levels.  She is happy with the amount of exercise I do on a weekly basis and that we tend to prepare our own meals rather than eat out.

The other advice I got from Dr. Johasz was to:
  • stop putting so much pressure on myself to over-achieve
  • try to relax once in a while.....
  • ..... with my husband too
  • try the Konditor and Cook salted caramel brownies available at the bottom of the Gherkin
I am so happy I was able to attend this physical after not having had one in over six years.  It was very professional and not once did I feel pressured to hurry up.  I felt I could really relate to the GP I met with and she was able to answer my concerns (mostly about the amount of Diet Coke and cookies I eat) in a non-condescending way.  She also gave me some tips on how to look at my moles for skin cancer (ABCDE) and reviewed how to perform a breast self-exam.

When I asked how often clients have one of these thorough physicals, she said it depends on the patients' preference.  Being located in central London, many people would find it easy to book an appointment in a lunch break for an annual check up.  Or some people might wait a year or two in between if they generally feel healthy and don't have any concerns.  The clinic also has more specific services for sexual health, same day urgent care, travel clinic and more.

Right on!
When was the last time you had a physical at the doctor's?  Do you think people should have one every year?

Thank you to Walk-In Clinic for this complimentary experience.  All opinions are honest and my own. 

 As a disclaimer, Dr. Juhasz doesn't normally recommend these brownies.  I mentioned celebrating with cookies and she suggested the local bakery.  She said I could cut back a bit on the sugar and that sleeping more would help me maintain consistent energy levels.

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