Physician discusses need for checkups, screenings

Dr. Brian Neely says it's important to have an honest conversation with your primary care provider to determine how to be proactive in your health care decisions.



January 27, 2023 - 2:31 PM

Dr. Brian Neely, a family practice physician with the Allen County Regional Hospital health clinic, talks about checkups and screenings. Photo by Vickie Moss / Iola Register

A bit of healthy curiosity can be a good thing.

Dr. Brian Neely recalls a patient who sought a cardiac screening not because he was worried about symptoms but simply because he was curious. 

The scan showed significant plaque buildup in the man’s heart that required a stent. While that sounds pretty serious, had he waited to show symptoms, he might have suffered a heart attack or worse.

An annual checkup and recommended screenings can identify problems before they develop into something more serious.

Knowing which types of screenings you need might seem overwhelming. It doesn’t have to be, Neely said. Neely is a family physician with Allen County Regional Hospital; his office is based at the Medical Arts Building at 826 E. Madison St.

Recommendations change every year and for a number or reasons, as medical professionals work to determine what is most beneficial to large groups of people.

For children, that typically means vaccinations.

For women, it means pap smears and mammograms.

For everyone after age 45, it means a colonoscopy.

And for those over age 60, it can mean cardio scans. 

Other screenings, such as for bone density or lung cancer, may also be recommended for certain people.

“A lot of people don’t think they need a screening because they aren’t having symptoms,” Neely said. “The whole point behind a screening is to find things before you have a problem. And if we do identify something, those things generally are more easily treated. The impact on the patient will be better and we can avoid bad outcomes.

“Unfortunately, if you wait for symptoms, the condition is often much more advanced.”

THE PROCESS typically starts by having a conversation with your primary care physician during a routine annual exam.

Your physician will discuss your medical and family history, and will recommend certain types of screenings based on those factors as well as recommendations by professional health organizations. 

“It seems like a little bit gets added each year as the technology gets better and treatments get better, and age recommendations change as well,” Neely said.

“Screenings are an important part of informed decision making. There should be a little bit of conversation between you and your provider.”

You or your physician might want to start with a blood test to screen for numerous medical conditions such as high cholesterol, anemia and thyroid functions, infections and other types of issues.

Then, they’ll recommend other screenings as deemed appropriate for your age, history and other considerations. The types of screenings needed vary with each individual.

Your physician also will know when you may be at less risk, and perhaps a screening isn’t recommended at the time.

WHEN  tests come back within the normal range, it gives a patient peace of mind and also more information to be added to their medical history.

“Doing those screenings establishes a baseline. This is what we have today, and you’ll have something to compare it with in the future,” Neely said.

“Mammograms are especially important for that. A lot of women will have something that’s been there for a long time. We see where it is today and then you follow that to see if it changes.

“Another big one we follow is lung cancer screenings that are indicated for people with a certain history of smoking. It’s not unusual to have some abnormalities in the chest, but if those change over time, you know there’s a higher risk.”

Most of the recommended screenings can be done locally, at Allen County Regional Hospital or at other health care provider facilities such as Community Health Center of Southeast Kansas. 

In some cases, ACRH may recommend a patient travel to an affiliated hospital in Garnett. An example is mammography; ACRH is in the process of being recertified to do mammography procedures but that service is not yet available. Officials expect it to return soon.

SO WHAT happens when a test result is abnormal?

It happens fairly regularly, Neely said. 

“The important thing to do is follow up so we can make the appropriate decisions to check things,” he said. “As much as you don’t want to find something bad, hopefully we’ve identified it early enough that we can make a difference.”

Sometimes, people are reluctant to have a screening because they’re afraid of what might be found. It may sound counterproductive — remember, screenings often identify a problem before it becomes serious — but Neely said he understands their fear. 

“There’s a fear of the unknown. And some people are embarrassed about symptoms and don’t want to talk about them,” Neely said.

“Some of the screenings, such as colonoscopies, mammograms and pap smears, can be a little bit invasive and some patients shy away from those.”

Many types of screenings need to be repeated in certain intervals, such as a mammogram every year or every other year depending on age. Others may not need to be repeated unless symptoms change. 

“Those intervals have been well-established through studies and agreed upon by experts in medical fields,” Neely said.

“And, again, that’s where a conversation with your physician comes in, so we know what tests we need to look at. That’s why family history is so important. And it’s also important to be honest.”

If a follow-up appointment is scheduled, it’s important to keep it. Most patients will have whatever follow-up is needed, Neely said, but sometimes “life comes up, things happen and sometimes people forget. It’s not always the first thing in mind because they’re not having symptoms, but people are generally well-intentioned and they’ll follow through.”

MOST screenings are covered by health insurance.

Each plan is different, though, so it’s important to check with your insurance company to verify if the procedure is covered.

In some cases, such as a CardioScan for those age 60 or older or who meet certain qualifications, a patient will need to pay the entire costs. When required, fees typically are kept relatively low. The CardioScan, for example, costs $60.

Some screenings require a referral from a primary care provider.

Neely understands that some patients may delay or avoid screenings because of financial concerns.

“Sometimes the cost is prohibitive,” he acknowledged. “But screenings identify things early, so in the long run it makes the costs better.”



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