Many activities in our daily lives require physical exams before we can participate. Children need physicals for sports or camps; teachers and other professions need physicals to qualify for employment; and operators of public transportation or large trucks regulated by federal law need drug and alcohol screenings.
What to Expect
Be prepared to provide a complete medical history and to fill out the necessary forms; be sure to bring the organization’s forms for the clinic to complete. Bring immunization history with you. A preparticipation physical evaluation (PPE) will always screen for some basic body signals:
- respiration rate
- heart rate
- auscultation of the heart (listening with a stethoscope)
- blood pressure
- clear eyes, ears, nose, and throat
In most cases blood will be drawn to ensure iron and oxygen levels are normal, and for other specialized purposes as may be required by law.
Often a urine sample is needed to make sure the genitourinary tract is functioning correctly. The doctor (and it should always be a doctor conducting the examination) is checking for pre-existing conditions that could be worsened by physical activity from the prospective program or employment.
For children (camp or sports physicals) the doctor will usually listen carefully to the heart with the adolescent squatting, sitting and standing to detect any possible heart murmurs related to hypertrophic cardiomyopathy.
For adolescent females, an examining doctor should be on the lookout for signs of the “female athlete triad,” a combination of three danger signals exclusive to young females involved in sports: osteoporosis (weakening of the bones), amenorrhea (irregular or absent menstrual cycle), and eating disorders.
The doctor may examine for normal muscle and bone development, including a visual spinal examination to check for scoliosis (spinal curvature).
Teachers and many other professionals are screened for work readiness through pre-employment physicals. As with children’s examinations, the doctor is watching for conditions that may be exacerbated by the demands of the job, such as lifting heavy objects, standing for sustained lengths of time, or repeated bending.
The federal Department of Transportation’s Federal Motor Carrier Safety Administration requires pre-employment screening for anyone wishing to operate under DOT regulations (public transportation drivers, interstate truck drivers and heavy equipment operators).
This screening checks for controlled substances and alcohol abuse. In addition to pre-employment screening, DOT permits post-accident exams, random testing, reasonable suspicion testing, return-to-duty testing, and follow-up testing. All require bloodwork and urinalysis.