School Uncertainty But Students Still Need Exams
By Craig Cooper
There will be many unknowns and uncertainties when school-age students return to class. The plans are as fluid as the sanitizer on our hands.
Will students be at their school, or will they be learning from home? Will there be some sort of hybrid learning environment?
Regardless of how and when students return to learning, there has been no indication that required vaccinations or back-to-school physical examinations will be postponed or waived.
If you haven’t already scheduled your students for physical exams for sports or for school, now is the time.
Genesis Health Group pediatrician Genet Giday, M.D., said back-to-school examinations and sports physicals are different but can be scheduled for one doctor visit.
A sports participation physical provides important information about whether your young athlete can safely participate in a sport. A back-to-school or wellness physical is intended to gather information about the patient unrelated to sports, but more importantly, allows the health provider to create a medical history for the patient.
A sports physical, for example, may not determine whether a student is up-to-date with a vaccination schedule. An appropriate vaccination routine is one of many topics the provider may discuss with a young patient and parents or guardian in a wellness physical.
At this time, there are no assurances there will be sports seasons but you want to be ready with a sports physical when sports resume.
The standard sports physical includes blood pressure, vision, and checking out heart, lungs, abdomen, ears, nose and throat. The exam provider will probably ask about previous sports injuries, hospitalizations or surgeries, chronic conditions such as asthma or diabetes, and any medications the student may be taking regularly.
The provider is trying to determine if there is any reason the young athlete should be withheld or restricted from participation in the activity because of high blood pressure or previous instances of sports-related concussion, dizziness, chest pain or difficulty breathing.
Dr. Giday said a participation physical in advance of an activity is important but it does not provide the same information, or the more thorough information, of a wellness physical. The provider may combine the examinations into one visit.
Exams Have Different Goals
Dr. Giday said wellness examinations help create a medical baseline for the young patient.
Providers want to have a history of a patient. The information helps the provider see how a patient is progressing from one visit to the next. The exams also give the provider information about chronic conditions, vision and hearing issues. Growth information is also charted.
More than ever before, providers also look beyond the physical exam and measurements to talk about lifestyle issues affecting overall health and especially mental health.
Mental Wellness Topics
The provider may ask about the time the patient spends with electronic devices and various media, how the patient is sleeping, are they sexually active, are they vaping or smoking cigarettes, are they using alcohol or illegal drugs, are they anxious or do they experience periods of depression? These conversations may take place when the parent or guardian is not in the exam room.
The point of the questions is to determine overall health. The answers will help the provider develop a response or plan of action if necessary. For example, a vaccination to prevent human papilloma virus (HPV) may be suggested to a pre-teen or teen, both females and males.
One reason for the mental health questions is that diagnoses of mental health disorders in young people are more common in recent years. Because of the stress and anxiety created by COVID-19, pediatrics providers have greater concern than ever before about mental health of patients.
According to the Centers for Disease Control and Prevention, 9.4 percent of children ages 2 to 17 are diagnosed with ADHD. Behavioral problems are diagnosed in 7.4 percent of children ages 3 to 17 and 7.1 percent ages 3-17 are diagnosed with anxiety. These statistics were reported prior to the COVID-19 outbreak.
The lifestyle and mental health questions are an important and vital difference between a sports physical and a well physical.
“The lifestyle questions are not intended to have patients share their secrets. The idea is to gather the information for a full, non-judgmental picture of the patient’s physical and mental health and to look at possible solutions to any conditions present,’’ Dr. Giday added. “When the school year approaches, especially the coming school year, I hope parents will make sure they schedule both physical exams and we can complete them in one appointment.’’
Dr. Giday is accepting new pediatrics patients at Genesis Health Group, Silvis Pediatrics. To make an appointment call (309) 281-2350 or go to www.genesishealth.com/pediatrics.
