Two views: Annual checkups

TRADITIONAL: DR. CATHERINE CERVIN, professor of medicine at Dalhousie University in Halifax

Doctors used to give everyone the same yearly checkup. Now we do screenings based on gender and age, and only those that have been clinically tested to prove they make a difference. Advisories are updated every year, and physicians keep abreast of new advances through mandatory continuing education.

Your M.D. should start by updating your history, checking your blood pressure and doing a breast and pelvic exam. She’ll check weight and height to calculate body mass index, and measure your waist, because women with a waistline of more than 88 centimetres have a higher risk of diabetes and heart disease. Depending on age, she might do blood work or prescribe a mammogram.

A physician should also ask about appetite and sleep. She should discuss medications with you, including herbal ones. She should ask about contraception, sexual history, how regular your periods are and when your last one was. Talking about relationships is also important; most doctors screen for abuse, because it’s a common situation women have trouble discussing.

Preventive care is a large part of family medicine. Yearly checkups are regular enough to catch most things. And getting lifestyle advice from physicians has an impact: It’s been proven that if a woman smokes, or drinks more than is recommended, advice and information from a doctor increase the likelihood that she’ll change her habits.

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ALTERNATIVE: IVA LLOYD, naturopathic doctor at Naturopathic Foundations Clinic in Markham, Ont.

In a routine physical, I examine the patient’s tongue, pulse, eyes, face, skin, feet and hands. In her eyes, I’m looking for that healthy sparkle. By looking at her tongue, I can assess her organ function. If a patient has irritable-bowel syndrome, for example, her tongue may be covered in red dots, because of toxins in her stomach.

I do the same tests a medical doctor does, such as breast exams. I might also ask the patient to track her body’s pH for a month, because acidity and chronic disease are connected. Or I’ll ask her to monitor her temperature. If it’s lower than normal (36.7 degrees Celsius), it’s possible that she has low thyroid function. If the patient doesn’t have a physician, I’ll request the basic lab tests, such as blood work, depending on her age and medical history.

Naturopaths aren’t commonly considered primary-care practitioners, but many of us are embracing that role. We follow guidelines for checkups, and all naturopathic doctors in British Columbia, Saskatchewan, Manitoba and Ontario must be registered and take continuing-education classes. While I encourage my patients to see an M.D. as well, only naturopaths stimulate the innate healing ability of the body. Health and disease are a continuum; you’re not healthy one day and sick the next. There are early signs that the body is heading toward illness. If you’re working with a naturopath, you’ll never get too far along the path of disease.