Back-to-School Physicals

Charles A. Welborn, MD, MPH, FAAP, FACEP
July 1, 2013

Parents: soon you will be rushing to buy clothes, school supplies and, oh yeah, get that health check-up completed.  Is it really all that important, you ask?  Your child has been running around all summer and judging by his appetite and outgrown clothes, seems very healthy.


The short answer is yes!  The annual school physical for children is quite important.  Most visits to the doctor during the school year are for focused problems, such as a sore throat or injury.  The annual pre-school check-up is a great opportunity to take a comprehensive look at your child’s health.


Perhaps the most important decision you make about the pre-school health examination is where it takes place.  Nowadays, there are many health care outlets that advertise and perform these evaluations quickly and cheaply.  While they may be able to fill out a piece of paper and perform a basic exam, is it really what your child needs?  Quite simply – no! 


Your child’s primary care physician provides continuity with records of growth, immunizations, medical history and ongoing care.  This is indispensable in providing a comprehensive assessment of your child and is impossible to duplicate. So, while there is certainly a time and benefit to taking advantage of urgent care center services, these centers simply cannot provide this level of care for back-to-school physicals.


For example, a child or adolescent’s growth is measured along a standardized growth curve and most follow a pattern that your doctor can immediately analyze based on prior measurements.  If there is a new trend to the growth that alerts your doctor to ask questions regarding nutrition, exercise and other symptoms, it might be related to an underlying medical condition.


Another important area is the determination of sports preparedness.  Your child’s doctor will assess the physical and sexual maturity and help guide you on which types of activities are suitable.  In recent years, there has been a large increase in sports-related injuries in children.  They usually occur because there is a mismatch between the physical maturity of the child and the type of sporting activity.  Many children want to ‘do it all’ and participate in multiple sports, but they might actually not be physically mature enough to do so.  As a result, ‘overuse’ injuries are now common and can be debilitating if not handled properly.


The assessment of emotional and behavioral health is as important as the physical elements of the pre-school evaluation.  Paralleling their physical growth, children, especially adolescents, undergo changes in how they interact with the world around them.  By assessing the emotional health and coping skills in conversations with the child as well as the parent, issues can be addressed quickly.  Your child’s primary care doctor will have lots of resources available to help address these issues.


So, the bottom line is to schedule NOW for your child’s pre-school health evaluation with your trusted doctor.  Don’t wait until the last minute and settle for getting a paper filled out by a stranger.