Michigan Surgical
Associates, P.C.

Specializing in General and
Laparoscopic Surgery

• Breast and Colon Cancer Screening

• Conveniently Located

•Variety of Office Hours

Affiliated With Many
Local Hospitals:

Eric A. Brown, M.D., F.A.C.S

William L. Kestenberg, M.D., F.A.C.S.

Joseph V. Rims, M.D., F.A.C.S.

Michael G. Taylor, M.D., F.A.C.S.

2/27
1998

130

Akash R. Sheth, M.D.

• Huron Valley-Sinai • Sinai • Troy Beaumont
• St. John Hospital And Medical Center
• St. John Macomb • Bon Secours
• Providence • Macomb Hospital Center
• St. John Oakland Hospital

Most Major Insurance Plans
Accepted:

• Medicaid/Medicare
• Blue Cross/Blue Shield
• Blue Care Network • Omnicare
• HAP • Selectcare • M Care • PPOM
• Wellness Plan • Aetna • Blue Cross PPO
• Smart Care • First Care • Cigna • PHCS
• Plus Many Others. Call For Details.

Health

symptoms, has a healthy lifestyle, but
her cholesterol level is over 200, I also
may want to see her on a regular basis.
On the other hand, much of my
advice to patients in their 20s and 30s
centers around sound nutritional
habits, exercising regularly, practicing
safe sex, and keeping immunizations
current. Unless a patient is at risk
based on medical history or symp-
toms, I don't recommend chest X-rays,
EKGs, or stress tests on a regular
basis."
Family planning and contraception
are also discussed with patients in
their 20s and 30s who schedule
appointments with Dr. Michael
Wayne, D.O., who has a family prac-
tice in Northville.
"If a patient is healthy and the
medical history doesn't show risk fac-
tors, I ask that my younger patients
see me for a physical exam every four
or five years," says Wayne. "If there's a
family history of diabetes and the
patient is in his 20s, I may ask to see
him every three years."
By the time a patient is 40, Drs.
Levine and Wayne expect to see their
patients every two to three years. By
the time patients are 45-50, they are
often asked to be examined annually,
especially for specific tests such as
colon cancer screening, prostrate
examinations for men and bone densi-
ty analysis for women.
"The mortality rate is 20 to 30 per-
cent for women who fracture their
hips due to osteoporosis," says Levine.
"I advise younger female patients
about the importance of calcium and
exercise, and I prefer to test the bone
density of women who are in their 40s
so that there's still time to change her
lifestyle or put her on medication or
do both."
Hedy Blatt of Farmington Hills sees
her gynecologist regularly, but also
believes strongly in a thorough annual
physical examination.
"I consider an annual physical exam
to be preventive," says Blatt. "If I'm
going to be sick, I want my disease
diagnosed early, giving me a better
chance to treat and cure the illness. I
expect the physician to ask about my
medical history and any recent com-
plaints, and then I want a comprehen-
sive exam, including a complete blood
work up, an EKG, and even a test for
flexibility.
"When the results are in, I expect
the doctor to discuss them with me.
That's my time to ask questions and
for the doctor to ask me questions so
he can better diagnose my symptoms."

The good news is that new tests
and imaging devices have helped make
diagnoses even more accurate and
sometimes replaced more invasive pro-
cedures. The bad news, however, is
that not all test results are equal.
According to Wayne, many insur-
ance companies dictate which labora-
tories to use for which tests and it's
not unusual for one lab to be better
than another.
"Since I can't control the lab work,
I always ask my patients to get a sec-
ond opinion whenever I find any
pathology from lab reports," Wayne
says.
Dr. Daniel Panush, an internist in
Southfield, would like a baseline lipid
profile for every patient to monitor
cardiovascular health, an annual Pap
test for all adult female patients, an
annual PSA level test for men over 40
to test for prostate cancer, annual rec-
tal exams for patients over 40, and a
sigmoidoscopy every three years for
patients over 50.
"There was a time when we gave a
chest X-ray to every patient and Blue
Cross or Medicare would cover the
costs," says Panush. "Now it's more
typical that we give chest X-rays every
3-5 years depending upon a patient's
risk factors and depending upon the
guidelines of the patient's medical
insurance coverage.
According to Gilbert Frimet, an
attorney specializing in health care law
in Southfield, patients should be ask-
ing themselves whether they're getting
the quality of care they expect, the
medical tests they think they ought to
have when they have a physical exam,
and whether the laboratory produces
quality work.
If a patient thinks she needs more
services, Frimet says, she'll need to be
insistent and vocal because govern-
ment programs and insurance plans
today pressure health plans and doc-
tors to provide less care.
The advice on physical exams is
consistent: Healthy or not so healthy,
patients need to be well-informed con-
sumers. Some physicians may not wel-
come having their expertise ques-
tioned but any doctor should be will-
ing to answer reasonable questions in
a reasonable manner.
The bottom line is that you should-
n't leave your checkups entirely to the
physician. It's up to you to make sure
you get all the tests you need and
avoid the ones you don't.
More importantly, a routine check-
up is your chance to go over your
medical history and note any changes