Even in your 20s, you should have a doctor you can see regularly

If you’re a young adult in your 20s and consider yourself healthy, going to the doctor for a checkup may be low on your priority list. Nearly 50 percent of people in their 20s don’t even have a primary care doctor.

But for 20-somethings, having a doctor you see regularly may be more necessary than you think.

Allison Ruff, a primary care doctor and clinical associate professor of internal medicine at the University of Michigan, thinks it’s essential.

“The truth is: Things really do happen. And if you get an illness, it gives you someone to see,” she said. “Having a relationship with a primary care doctor gives you someone to call when you need someone, even if you thought you never would need someone.”

Richard Chung, an adolescent and young adult medicine specialist at Duke Health, agrees. “Many health issues, especially in this earlier time of adulthood, may not be obvious to the person … and yet they do have health impacts both today and also into the far future,” Chung says. “And so getting a checkup … is a great opportunity just to confirm that these issues are not starting up for a particular young person.”

A variety of chronic conditions can start to develop in your 20s — or even earlier — that can be harmful long term if left untreated.

For example, more than one-fifth of adults in the United States between ages 18 and 39 have high blood pressure. Although it may not cause problems in the short term, if left untreated, it can lead to other serious conditions such as heart disease, kidney disease and stroke later in life. Luckily, doctors can easily screen for high blood pressure at appointments and can recommend lifestyle changes and medication if needed.

Similarly, nearly one-quarter of adults 18 to 44 have prediabetes, which without treatment generally develops into true diabetes. Fortunately, as with high blood pressure, prompt recognition and lifestyle changes can help prevent the downstream consequences. If caught too late, however, some of the health effects may be irreversible.

These are just a few examples of why a young adult can benefit from a visit to a doctor at least every few years.

If you find yourself going to the doctor for the first time since you saw your pediatrician, here is what you can expect:

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Routine checkups are fairly standard, meaning that you generally know what to anticipate. As soon as you check in for your appointment, you can expect to fill out screening tests. For example, you may be asked to fill out a questionnaire about signs or symptoms of depression. Next, a medical assistant will take your pulse, blood pressure and temperature, and measure your height and weight.

Once the doctor enters the clinic room, the visit usually starts by getting to know you and addressing any specific concerns you may have. “If you came to the office not just to establish care but because one of your loved ones is prodding you to get something taken care of or have someone look at a mole, or you’re having a lot of anxiety or you’re interested in preventing pregnancy — whatever that may be — we’ll address that first, get it off your mind,” Ruff said.

You should also be ready to talk about your medical history. “What is their health history?” Chung said. “What conditions have they been diagnosed with in the past? What injuries or procedures or other facets of their health history should we know about so we can understand who they are and what they might need? If they are taking medications or over-the-counter treatments of any sort, that’s all relevant, so that we have a full context for then assessing and making recommendations that day.”

It’s equally important to know about the health of your family members. “So do all of your family members have heart disease, or is it common for people to get a certain kind of cancer really early? And then we’ll address what we can do to prevent that for you,” Ruff said.

Lastly, the doctor will ask about your “social history.” In this portion of the visit, the doctor will ask about behaviors that contribute to health.

It’s “really important that young folks know we do this at every visit … we really need to understand their overall health habits,” Ruff said. “So are you smoking? Are you vaping? What does your relationship with alcohol look like? And it’s important for folks to know: It’s okay to have a relationship with alcohol, it’s okay to have an active sex life. … We want to make sure that you’re doing these things and participating in these behaviors as safely as you can.”

After completion of the history comes the thorough head-to-toe physical exam. Chung said the goal is to “make sure none of these signs of potential health problems are there.”

Near the end of the visit, the doctor will work with you to determine the next steps.

“The health-care provider will make a recommendation around what might be needed on that day to keep that young person well. So that could be updating immunizations, it could be getting certain screening lab tests, or just kind of making recommendations around health behaviors or other things,” Chung said.

While many screening tests are not recommended until later in life, there are still several recommended tests for younger adults.

People in their 20s with cervices need Pap smears every three years, although the interval may be shorter if you’ve had abnormal results in the past. Those who are sexually active can expect routine screening for sexually transmitted infections, many of which may be asymptomatic, and it’s recommended that everyone is screened for HIV at least once in their lives and in many cases for hepatitis C, as well.

Depending on your risk factors, your doctor may recommend other blood tests that check for such diseases as diabetes and high cholesterol.

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You can expect fewer vaccines than in childhood, although it’s not too late to catch up on vaccinations you may have missed, such as the one against human papillomavirus.

You’ll also need a tetanus booster every 10 years, and it is strongly recommended that everyone get a flu vaccine every year. Of course, the doctor will ask whether you’ve had all recommended doses of the coronavirus vaccine. Depending on your medical conditions, your doctor may advise other vaccines or screening tests.

Ruff drove home the importance of yearly checkups even for young people: “I think having a primary care doctor who you can go to, who knows you, who can answer basic questions, treat you for everything from a cold to cancer, it’s important. And I think having that relationship is super important.”

Netana Markovitz is a resident physician in internal medicine at Beth Israel Deaconess/Harvard Medical School in Boston.

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