Paper hospital gowns and fluorescent lighting are no substitute for kicking back with beers during the March Madness—but your annual checkup should be about your doc getting to know you. Along with updating vaccinations and some routine testing, talking about your lifestyle and potential risk factors for disease is why you come in for a preventive exam, says Minesh Khatri, M.D., assistant professor of medicine and a general internist at Columbia University Medical Center.

To make the most of your time (and your doc’s), come prepared with a list of questions you know you want answered to help focus the visit, he says. And mention anything that is bothering you—a mole, a sleep problem, a rash, or whatever—at the beginning of the exam, so the doc can address the concern and organize the rest of the visit to make sure it’s taken care of.

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1. Any red flags in my family history?

Early heart disease in every generation is probably not a coincidence… Family medical histories help the doc determine future health risks—and may be reason to recommend earlier or more frequent screening for certain conditions. For instance, if there’s a strong history of colon cancer in the family, regular colonoscopies should start earlier than the recommended age of 50, Khatri says.

The more info you can share with your M.D., the better. Most important to note are major illness or diagnoses in primary relatives (parents, sibling, and children) and being aware of any unusual trends in more distant relatives (aunts, uncles, and grandparents). The doc will likely ask about cancer and heart disease, but it’s also helpful to point out conditions like arthritis, diabetes, or depression.

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2. Do I need to update any shots?

Expect your doc to recommend an annual flu shot, and that you get a tetanus booster every 10 years. Otherwise, there may be additional vaccines based on your personal risk profile (family history, lifestyle, etc.) that your doc will suggest, such as the hepatitis B vaccine or the HPV vaccine (see #8).

If you're seeing a new doctor for the first time, know your immunization history before your visit, advises Khatri. If you don’t remember, call your previous doctor’s office.

3. What tests or screens do I need?

As part of an annual or preventive exam, most doctors will order a series of blood tests (such as blood counts, thyroid levels, vitamin B levels, etc.) as well as a blood pressure check. But beyond that, it all depends on your family history and individual risk factors, Khatri says. 

Other risk factors your doc may suggest you act on: family history of diabetes, or early prostate cancer or heart disease.

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4. How often should I get my cholesterol checked?

High cholesterol is one of the first signs you may be at higher risk for heart disease and stroke—and it should not be ignored. American Heart Association guidelines recommend getting your levels checked once every five years, but depending on your numbers and other risk factors, your doc may recommend getting checked more often, says Khatri. "If you're young, healthy, and your cholesterol is great, you probably don't need to be screened for another five years—but if you're borderline and overweight, you may want to get it checked the following year."

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5. Is my diet healthy?

Everyone has a different take on what defines a “healthy” diet—but what you eat lays the foundation for health down the road. Your doctor can weigh in on whether you eat out too much (or how to make smarter choices when ordering out) or if there are certain foods or nutrients you should be getting more of.

Why ask your doctor? Some bad eating habits won’t be picked up on tests (or won’t show until they’re a problem)—but those habits will catch up with you down the line, Khatri says. Small eating habit tweaks are often very fixable, but can have big long-term implications.

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6. Do I need to lose weight?

Weight is one of those topics people tend to “shovel under the rug” and not pay enough attention to, Khatri says—but it has everything to do with long-term health. Patients definitely can and should ask their doc for advice on weight-loss strategies that would be most likely to work based on other lifestyle factors. Ask for feedback on whether or not you’re getting enough exercise, and how to eat healthier.

7. Do I need to drink less?

Okay—you probably didn’t forget to ask this one… But, how much you drink (as well as smoking habits and drug use) definitely affects long-term health, and helps the doc determine your risk level for illness or complications. Being as truthful as possible helps the doctor better tailor your care to your needs, Khatri says. “And remember, it’s all confidential at the end of the day.”

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8. Should I get the HPV vaccine?

No, it’s not just for girls anymore. The HPV vaccine is now recommended for guys up to age 21—as it’s been shown to help prevent anal cancer and genital warts in men, and researchers suspect it can prevent cancers of the mouth, throat, and penis as well. And for guys between ages 22 and 26, it’s recommended that the vaccine be considered for those with additional risks, such as men who have sex with men, men with compromised immune systems, or for those who were never vaccinated.

9. Should I be tested for STDs?

Still confidential—and when it comes to your doc, you can’t get too personal… Though often not talked about enough, your doctor should know about your sex life, Khatri says. Recommendations for STD testing vary depending on age, risk factors, how often you’re having sex, and who you’re having sex with. That’s why being upfront lets the doctor recommend what’s ideal for you.

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10. When do I need to come back?

Though many insurance plans cover the cost for an annual preventive exam with your primary care doc, if tests are normal and you’re generally healthy, coming back every two years or more may be OK. But if you have a strong family history of early heart disease or early cancer—or if you have high blood pressure—aim to see your doctor yearly to get those things checked out, Khatri says. “It depends on the individual and your risk factors.”

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