Pre-Retirement Physical?

[Midpack]

I am closing in on the retirement point of no return and thought I should have a complete physical soon. Seems the basic physical might not be adequate, but what all should a reasonably comprehensive pre-retirement physical include? I feel fine (just old), but I'd hate to retire only to find out I have a grapefruit sized tumor in my head or some rare, curable disease? I did a search here and on Google and didn't turn up anything. I'll be contacting my GP soon, thought I'd do a little research first since he's only done basic physicals on me before...

 

[bizlady]

I'd make sure you have post retirement insurance in place. In the unlikely event something big is found, you'd hate to be uninsurable....

 

[braumeister]

Not an answer, but be careful about this.
Some people go for what they think is the maximum, and get very sophisticated tests like full-body CT or MRI scans to look for little things they believe might be missed with normal exams like X-rays.

What sometimes happens is that little spots show up on the scans, and invasive biopsies are required to see what they are. Usually, they turn out to be nothing, but the expense and risk of these follow-ups can be significant.

An acquaintance went through this process, and the scan picked up a spot in his lung. That led to opening his chest up to take a look at it, and by the time they were done, an infection had set in. He barely got out of the hospital alive, weeks later.

I'll grant you this is unusual, but it happens. I would just talk with your regular physician and discuss it with him/her.

 

[Rich_by_the_Bay]

Braumeister has it right. Very few diseases qualify for screening and such screening is usually basic labs; colonoscopy being a common exception to the "basic" category.

Barring symptoms or high risk factors, doing more tends to cause more harm than benefit from a probability standpoint. Incidental troublesome findings that get aggressively worked up, procedures that can be risky. I opt to limit screening to those tests that have proven that athey save lives or improve quality of life.

Then there's cost...

 

[HawkeyeNFO]

I too echo Braumeister. Sending a doctor on a wild goose chase rarely helps a patient. In this case you don't even have symptoms to begin the search.
Additionally, in this case, a CT scan would be a HUGE dose of unnecessary radiation.

 

[Alan]

I am closing in on the retirement point of no return and thought I should have a complete physical soon. Seems the basic physical might not be adequate, but what all should a reasonably comprehensive pre-retirement physical include? I feel fine (just old), but I'd hate to retire only to find out I have a grapefruit sized tumor in my head or some rare, curable disease? I did a search here and on Google and didn't turn up anything. I'll be contacting my GP soon, thought I'd do a little research first since he's only done basic physicals on me before...

Are you considering this because you are going to have worse Health Insurance in retirement ?

In retirement my HI pays for an annual physical that includes the usual blood work, PSA test, DRE, at rest EKG etc. As others have said I wouldn't go into CT scans and the like.

I did have a tread mill stress test and colonoscopy in the 2 years before I retired, at the company Doc's suggestion, plus made sure I got my dental visits in.

 

[kyounge1956]

I discussed a "pre flight check" with my dentist last time I was in. I've never had any major problems with my teeth, but I'm planning to have them checked very carefully and get any necessary work done before I retire, because after that I'll be paying for dental care out of pocket.

 

[Alan]

I discussed a "pre flight check" with my dentist last time I was in. I've never had any major problems with my teeth, but I'm planning to have them checked very carefully and get any necessary work done before I retire, because after that I'll be paying for dental care out of pocket.

On my "pre flight check" the dentist said I had a large filling that needed to be replaced. I asked if a crown would be better and last longer and he agreed but said that the insurance company would only pay 50% for a crown, but that I would need a crown in a year or 2. I'd had crowns done by him before and the procedure for a crown and a large filling is not much different and I've not needed a crown replacing ever, and it has been many years.

50% is a lot better than the 100% I'd be paying in ER.

 

[Nords]

I know you're not in the military, but this question has a lot in common with the military's medical perspective. I don't know if your company's health insurance requires a pre-retirement physical but there might be corporate liability concern that they're able to prove you were in good health when you wrenched yourself free of their tender ministrations. So they're not necessarily interested in answering your questions-- only in making sure that you pass a pulse/respiratory check.

Meanwhile you just want to know if any of the problems you experienced during your career are "their fault" or will get worse in retirement.

I put up a retirement-countdown brainstorming post a while back:
http://www.early-retirement.org/forums/f29/how-do-did-you-prepare-for-er-20952.html#post387098
with this specific medical advice:

Max out all the company's medical/dental benefits. It's best to start on this step a year out. That includes physicals, bloodwork, cleanings, and even prescriptions. Have every medical issue examined & resolved (or at least documented) since it may affect future insurability (and military disability). I even knew veterans who decided to have their last pregnancy on the military dollar. The rounds of medical bureaucracy-- consultations, referrals, physical therapy, and other treatments-- could take months.

What can the company do for your spouse/kids before you're outta there? Make sure you take care of their medical/dental/personal needs-- including dermatology, orthodontia, school sports physicals, scholarship applications, company internships, or other programs.

Later I added to it here:
Medical and dental exams | Military Retirement & Financial Independence

I guess if there's any exam or testing that needed to be done with a 2011 date then this would be the time to get it done. And if you're planning to relocate or change health plans then it'd be good to have a large stash of any maintenance medications before the cutoff date.

I had a shipmate who avoided dentists like the plague, but when it came to getting their signature on his retirement checklist they finally made him confront his delinquency. The downside is that he went through eight root canals over the next couple months.

I don't know how to handle the eligibility for retirement health insurance. As a couple other posters have mentioned, you'd hate for this "routine physical" to turn up some innocuous (or mistaken) test parameter that would later be used as an excuse to deny coverage for a hypothetical pre-existing condition. I wonder if there's any way to keep the physical "private" and out of the medical computer network. If there's no other checklist for a physical then maybe you'd want to at least make sure you have an exam typical of what you'd get for a health-insurance application. That way you'd get a free look at anything that might be an issue when you really apply for the insurance.

You may not need to worry about borderline numbers for cholesterol, blood pressure, and weight. I suspect that the best treatment protocol for those conditions is retirement...

 

[Alan]

You may not need to worry about borderline numbers for cholesterol, blood pressure, and weight. I suspect that the best treatment protocol for those conditions is retirement...

Quite correct in my experience.

 

[Danmar]

Not sure why a pre reirement physical is needed but we get an annual physical that is quite extensive and includes: abdominal ultrasound, hearing/eyesite tests, stress ekg, body composition measurement, physical fitness assessment, colonoscopy(every 5 years), all the blood tests, reviews of skin moles,etc. along with a 30 minute MD consultation to review results in real time. This costs about $2k each and is not covered by Candian universal health care system. When I was employed my employer paid for it. Not any more.

 

[Moscyn]

Before I retired, I checked what's the max I could tap on my then employer's health benefits provisions so that I can use up my allocation. At that time I was entitled to annual physical which is very thorough including scans on organs, bone density, thread mill test, etc. I made sure I went for all that about 3 months before I retired so that any follow up tests can hopefully be done before my retirement date. I also went for a dental check up and did some crowning. A colonoscopy also took care of a benign polyp. I did a dermatologist visit too to address certain skin concerns which I have always been thinking of but never got the time to see the doctor when working. One of these sophisticated test - the thread mill reveal some uneven heart beating and I was sent to another sophisticated test but not an overly intrusive one which is to scan my blood vessel diagonally. Turned out it was a false alarm. I guess some tests may always reveal concerns which doctors may send you on a wild goose chase but I would prefer to be tested than not (especially when those tests are paid by my employer). If something shows up, I can then decide whether to do further tests.

 

[chinaco]

I started getting one every year when I reached my late 40's. This year will be no different. I am getting ready to set up the appointment.



But I did put off getting "scoped" for a few years. Couldn't get the courage up. Finally did it about a year ago.

Apparently I was in good health.... the doc said everything was fine... no need to come back for another "procedure" till 10 years.

 

[GregLee]

Additionally, in this case, a CT scan would be a HUGE dose of unnecessary radiation.

I'm skeptical about both the adjectives "HUGE" and "unnecessary". What counts for whether it's "HUGE" is the risk of the CT causing a future cancer --- so how great is that risk? Here is a reference to a thread discussing that, where I've given a reference to a web calculator which purports to estimate the risk: The Colon Club • View topic - MD's Urge Tracking of Xrays, CT's, etc. .

Is a full body CT scan "unnecessary"? The bottom line is: does it extend life? And I don't know the answer to that, but I'm not willing to just assume that it doesn't. In my own case, I've asked that the yearly CT scans that I have to have anyway to check for a recurrence of my rectal cancer be extended to include my chest, since I have read of some evidence that CT scans are better at detecting lung cancer than X-rays. I'm worried about lung cancer because the lung is a favorite place for colorectal cancer to metastasize to, and also because I smoked for many years.

 

[Midpack]

We will still have health insurance after I retire, but more expensive and not as good as my current plan. I am perfectly healthy as far as I know and don't have any health issue history at all (though DW who is on my plan has some history), but I was thinking if there is a serious health problem that could be easily detected, I might delay retirement until that's been addressed. I am in an HDHP/HSA plan where the first $5K is at my expense, but most preventive is excluded, like physicals. I had a colonoscopy 6 years ago, completely clean, and told to get another at age 60. So it sounds like I should just have a complete but routine physical and don't go looking for a tumor in my head.

 

[Alan]

Just a reminder to spend your FSA if you have one. If you decide to wait until 2012 also remember that you can spend your entire FSA entitlement up front. My employer was actually very good about telling me about this. In November 2009 I elected to put $100/month into my FSA in 2010. In January 2010 I then spent all $1,200 on dental treatment, eye exam and new prescription glasses including an extra pair of prescription sunglasses.