A Reality Check on Trump’s ‘Interim Checkup’

If you’re confused about the President’s recent doctor’s visit, you’re not alone

EEarly Sunday morning, President Donald Trump tweeted about his impromptu visit to the Walter Reed National Military Medical Center in Bethesda, Maryland, on Saturday, where he reported visiting a military family and undergoing “phase one” of his routine annual physical exam.

“Those are truly some of the best doctors anywhere in the world,” he wrote of the hospital. “Also began phase one of my yearly physical. Everything very good (great!). Will complete next year.”

In a statement on Fox News, White House Press Secretary Stephanie Grisham refuted concerns about the president’s health, stated that he had a “quick exam and labs” and simply wanted to take advantage of some downtime by getting started on a “portion of his routine annual physical exam” before a busy year ahead.

After some media speculation about the president’s health (including why he would go to the doctor, on Saturday, before his annual physical was due), his physician released a memo clarifying that the visit was an “interim checkup,” and that “primary preventative medical care is something that occurs continuously throughout the year.”

But questions still remain: Namely, are physical exams ever completed in “phases,” and are “interim check-ups” a routine part of medical care?

Dr. Kathryn Boling, a primary care provider at Mercy Personal Physicians in Lutherville, MD, says not that she knows of. Since the president’s last physical exam was in February 2019, it doesn’t add up that he would have a second physical — even “phase one” of said physical — in the same calendar year, she says.

Technically, like most other doctor’s office visits, physicals do have multiple parts, like blood work, a hands-on physical exam, and in the case of a patient like the president (given his age and risk factors like historically elevated cholesterol), possibly an EKG. But Boling says usually these things happen in the same appointment, or at least on the same day.

“I’ve never heard anyone tell me that they had a ‘phase’ of their physical, and I’ve never done one that way myself,” she says. “Most of the time, if you’re going before the physical is due, it’s because you’re having some kind of medical issue that’s being looked at.”

“I’ve never heard ‘phases’ before, but if something concerning comes up in a physical or lab work, you might have another follow-up visit to further discuss what came up, and the treatment and management of that issue.”

The same is true for an “interim checkup.” Boling says if someone is coming in for an interim checkup, there’s typically an issue that’s getting checked out.

Dr. Ian Nelligan, a primary care provider at at Stanford Health Care, says while annual physicals aren’t typically done in multiple parts, a routine physical could lead to a follow up. “I’ve never heard ‘phases’ before, but sometimes if something concerning comes up in a physical or lab work, you might have another follow-up visit to further discuss what came up, and the treatment and management of that issue,” he says.

But doctors don’t typically think of follow-up visits as a continuation of an initial visit, according to Dr. John Mafi, a general internist and assistant professor of medicine at the David Geffen School of Medicine at UCLA. “If something comes up during the annual physical, like a patient’s blood pressure was a little high or they were having trouble with a medication’s side effects, they might come back sooner for a follow-up. But usually that’s considered a separate visit,” he says. “Whether you want to call that phase two is up to you.”

While some practitioners and practices may have different approaches in how they conduct physicals, Nelligan says, simply for practicality’s sake, it usually wouldn’t make sense to break up someone’s physical into “phases” — especially if the person is as busy as the president. “Out of respect to our patients’ time and our time, it makes sense to do it all at once. There’s not a whole lot of justification or reason to break it up and have to come into the doctor twice,” he says.

Keeping follow-up appointments close together is beneficial for a person’s overall well-being. For example, if you have your blood drawn at an appointment in November, you would want your physical examination — which Boling says is usually a 30-minute or shorter trip to the doctor’s office — at the same time. A February exam appointment would likely require separate blood work. “You want a health picture that’s consistent with everything you’ve done,” she says. “Otherwise, you could definitely miss something.”

No matter who is seeking a physical and when, Nelligan believes it’s important to keep the doctor-patient relationship at the center of preventative care appointments like physical exams. “Since the physical is a visit we use to review preventative health screening guidelines and optimize health, it’s important to do physicals with your primary care provider, the person who knows you best, and is familiar with your health and risk factors,” he says.

Writer-mom hybrid. Health & psychology stories in NYT, WaPo, Allure, Real Simple, & more.

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