This time of year, my office tends to see parents making appointments for child Physicals when really, they need a Well Visit, and vice-versa. That’s because there are some similarities between the two: both are visits for kids who appear healthy. They also both involve a physical exam. But really, that’s about where the overlap ends.
The differences between a Child Well Visit and Child Physical
While many use the terms interchangeably, there are many variations between a Physical exam and a typical Well Visit.
What’s involved in a Physical exam?
A Physical is literally—and only—a physical examination of your youngster. This visit begins with a short conversation about how your child is doing, whether there have been any noticeable physical changes lately, and what, if any, questions or physiological concerns you’d like to discuss with your healthcare expert.
After that, you can expect an assessment of your child’s body parts and all their miraculous functions.
Your child’s doctor will start this Physical exam with the main inspections: we’ll measure their weight and height, and we’ll look at their eyes, ears, nose, throat and mouth. We’ll also check your child’s blood pressure and blood oxygen level.
By this point in the visit, I notice that kids tend to be relaxed enough to allow us to use a stethoscope to listen to the heart and lung functions. Finally, we’ll feel their tummies to be sure everything inside is the right size and tonality, and we may tap joints with an instrument to ensure the nervous system is working well.
Many schools require a physical exam before starting classes. But other events like enrollment in sports or the introduction of a new foster family can also prompt this particular type of visit to your pediatrician. And if all else fails, your kid will receive a Physical anytime they come in for a Well Visit.
What’s involved in a Well Visit?
That’s right, a Physical exam is one portion of a full Well Visit. Well Visits are also known as annual checkups.
The main difference between a Physical and a Well Visit is that the Physical exam is included within a Well Visit… but during a Well Visit, the physiological assessment is just the beginning.
Once your child’s doctor has evaluated your child’s bodily health, it’s time for us to get a good, wholistic, 360-degree view of the entire child. That means your pediatrician will evaluate the child’s mental, emotional, social, environmental and behavioral health. They’ll cover questions like…
- Has anything changed about your child’s genetics or family medical history? What about their elders’ mental health? Are there updates to note that may impact the child’s susceptibility?
- Is your child meeting academic milestones at school? Are there any issues focusing in class or behaving well during the appropriate times?
- What kinds of varying moods or anxiety does your child experience? Are they mild, moderate or severe? Are they frequent? Are any “big feelings” progressing (“getting bigger”)?
- How does your child manage negative or unwanted thoughts and emotions?
- What is your child’s school routine and typical childcare arrangement?
- How has the child been sleeping? What time do they typically go to sleep and wake up?
- For pre-teen and teen girls, what premenstrual syndrome (PMS) symptoms have you both noticed, and how severe are they? Does she cope in healthy ways?
- What are your child’s friends like? How do they manage their social media use? Has the child seen or experienced anything on social channels that has been bothering them?
All these questions are asked in context with the child’s age and development. Sometimes we’ll address the child directly, and sometimes you as the parent will be encouraged to answer. The briefing builds an ongoing relationship. And this part cannot be stressed enough: that ongoing relationship serves two crucial purposes.
Often, we can sense from our clinical interview that a child is more at risk for an injury, illness or condition based on a combination of factors.
Family history plus unhealthy coping mechanisms, when combined with a big life event or circumstance, for example, can add up to a holistically hazardous picture. But it’s not a problem, because that’s exactly what Well Visits are for. We spot these dangers before they have a chance to develop into problems.
I remember specifically seeing a young girl regularly during her early childhood years. Her family and I developed a great working relationship keeping her healthy and happy. For whatever reason, she missed a few years’ worth of Well Visits, and when she came back, she was more than a little overweight. Dealing with childhood obesity (in this case) is much easier when we can prevent the weight gain rather than treat the resulting diseases like diabetes.
You know, the National Institutes of Health reports that kids miss 30%-50% of their Well Visits, so my young friend’s story isn’t uncommon. But for kids who keep current, we can often prevent…
- Cutting and other self-harming behaviors. When we notice a youngster looking for ways to alleviate their own symptoms of depression, we can refer them to a trusted counselor who knows exactly how to help.
- A lapse in vaccinations. If we hear a parent express trepidation because of a popular article circulating, we can address those concerns with factual data.
- Eating disorders. When we realize a young person has been feeling out of control of their life or bullied over their appearance, we can refer them to the best specialists to reverse those mental messages.
- Risky behaviors like drinking or vaping. If we decipher an unwillingness to stand up to peers, or an especially adventurous, “curious” personality developing, we’ll address these pitfalls in the office so your child understands the risks and consequences before getting involved.
- Unnecessarily heavy menstrual flows and PMS symptoms. You may never know whether your young teen is struggling needlessly if no one asks the right questions in the right environment.
Yes, prevention is every doctor’s favorite word, but the phrase early detection is a close second. From genetic conditions, lifestyle diseases and infections to anxiety, behavioral disorders, and learning disabilities, early intervention is so key to treating issues before they become catastrophic problems. This way, we alleviate the problems now while setting kids up for future success.
Take depression, for instance. Only about half of all kids with depression get an accurate diagnosis before adulthood, where the stresses of life continue to compound. If we could detect those mental struggles early on, then adulthood could be something to look forward to, not just a dreaded unknown.
Why Well Visits and Physicals matter
Among other benefits, kids who attend their regular Well Child appointments experience reduced hospitalizations and emergency room visits, something all parents can appreciate.
Well Visits (and the Physicals they involve) help kids establish a unique relationship with their care providers. The regularity of these visits allows us to become a trusted person in their lives. In time, when kids grow up knowing their doctors, they become adolescents who are open and honest with us about their emotional and physical questions or concerns, things that they feel uncomfortable addressing with other adults in their lives. And to me, that’s the best benefit of all.
Is your child due for a Well Visit? Make an appointment with your child’s doctor today, or find one near you.
About the author
Jamie Avila, MD, FAAP, is a pediatrician on the medical staff and medical director at Baylor Scott & White McLane Children’s Clinic – Killeen. Dr. Avila is also the division director of general pediatrics for the Central Texas region. Schedule an appointment with Dr. Avila today.