
WELL VISIT
WELL VISIT
Routinely screens for and prevents problems based upon preventive guidelines.
Routinely screens for and prevents problems based upon preventive guidelines.
​We are open for both In Person and Telehealth (portal, telephone, video) visits.
EXAMPLES​
EXAMPLES​
PSYCHIATRY
Unhealthy Drug
..opioid, cannabis, stimulant, sedative hypnotic
..tobacco
..alcohol
Depression (Lifeline 800.273.8255, text 998)
Healthy Diet + Physical Activity
CARDIOVASCULAR
Hypertension (annually: age 40+, African, hypertension, overweight/obese; otherwise age 18-39 every 3-5 yrs)
Lipid (age 35+ male, risk factors)
Abdominal Aortic Aneurysm (age 65-75 if ever smoker)
Statin for cardiovascular disease 10 year risk 10+%)
INFECTION
Sexually Transmitted Infection Prevention (safe sex: limit partner, verify status, use condom)
HIV (exposure, age 15-65 x 1+, pregnant, Man Sex with Man HIV+ partner, IV drug use, or transactional/commercial sex, inconsistent condom use when not in a mutually monogamous relationship, every 3-6 mo)
..Pre-Exposure Prophylaxis (PrEP): Man Sex with Man, HIV+ partner, inconsistent condom use, syphilis/gonorrhea/chlamydia within 6 mo)
PrEP reduces relative risk by 54% (73% if compliance is >=70%) so still limit partners, verify status, and use condom
Hepatitis B (exposure, born Asia/Africa, IV Drug Abuse, Men having Sex with Men, pregnant)
Syphilis (exposure, Man Sex with Man, prostitute, HIV+ living partner)
Hepatitis C (age 18-79 x 1+, exposure, born 1945-65, transfuse/transplant, IV Drug Abuse, liver disease)
Chlamydia + Gonorrhea (exposure, female sexually active age <=24 or age 25+ with new/multiple partner(s), symptoms)
Latent Tuberculosis (former resident in country at risk, homeless, prison)
Immunizations (may obtain at pharmacy)
.. Pediatric
..Adult
COVID x 2+ when to get a booster
flu: annual (LIVE VERSION NOT RECOMMENDED FOR PREGNANT or IMMUNOCOMPROMISED), inactive version recommended for immunocompromised)
TDaP: every 10 years
MMR (NOT RECOMMENDED FOR PREGNANT OR IMMUNOCOMPROMISED)
VAR x 2 if no history of vaccination or disease (NOT RECOMMENDED FOR PREGNANT OR IMMUNOCOMPROMISED)
HepB x 3 (if
PCV15 or PCV20 (if age >=age65 and no history of any pneumococcal vaccination, new CDC recommendation)
..Additional Immunizations for Specific Populations
Pregnant: 1 TDaP each pregnancy week 27-36 (CONTRAINDICATED: LIVE FLU, MMR, VAR, HPV SO DO NOT GET)
Immunocompromised: shingles RZV, pneumococcal (CONTRAINDICATED: LIVE FLU, MMR, VAR SO DO NOT GET)
Chronic Liver Disease: hepA
Healthcare Personnel: shingles RZV
Men who have Sex with Men : shingles RZV age 50+, HPV <=age26, monkeypox if exposure https://myturn.ca.gov/
CANCER
Breast Cancer
..mammogram (biennial age 50-74) may consider biennial age 40-49, option for annual age 40+
..BRCA gene (also for Ovarian Cancer)
known family BRCA mutation
Ashkenazi Jewish woman: breast or ovarian cancer in 1st degree relative or two 2nd degree relatives
1st degree relative(s) with breast cancer: two relatives or one relative with bilateral
1st or 2nd degree relatives: three with breast cancer or comorbid breast and ovarian cancers or two with ovarian cancer
male family member with breast cancer
..endocrine Rx new including for
age 65+ with 1 first-degree relative with breast cancer
age 45+ with more than 1 first-degree relative with breast cancer or 1 first-degree relative who developed breast cancer before age 50
age 40+ with a first-degree relative with bilateral breast cancer
presence of atypical ductal or lobular hyperplasia or lobular carcinoma in situ on a prior biopsy
Cervical Cancer (every 3 yrs age 21-65; every 5 yrs age 30-65 if Pap and HPV normal)
Colon Cancer (newly lowered age 45-75, especially black/native, family history, male, obese, diabetes, smoker, alcohol)
..Options
high-sensitivity guaiac fecal occult blood test (HSgFOBT) or FIT fecal immunochemical test annually
stool DNA-FIT (ColoGuard) every 1 to 3 years
virtual colonoscopy (computed tomography colonography) every 5 years
flexible sigmoidoscopy every 5 years
flexible sigmoidoscopy every 10 years + annual FIT
colonoscopy screening every 10 years (preferred)
Lung Cancer (updated: age 50-80 + 20 pack yrs + smoker <=15 yrs)
Prostate Cancer (age 55-69) option for annual blood/exam age 50+ (age 35+ if African or family history)
ABUSE
Intimate Partner Violence (childbearing age female)
ENDOCRINOLOGY
Diabetes (age 35-70 overweight/obese, Family History, ethnicity: African, Native, Asian, Hispanic, Pacific Islanders)
Osteoporosis (age 65+ female)
DERMATOLOGY
Skin Cancer if fair skinned (shade 10AM-4PM, cover, SPF 15+)
PREGNANCY PLANNING
folic acid 400-800ug daily