Every student should have an annual physical examination before going back to school to begin the new term. In many states, this medical examination is mandated by law and most schools require that a medical form be filled out before the child is permitted to attend classes. This checkup is necessary for the child’s health and well-being and for the health of everyone else in the school environment. A typical physical examination includes the taking of a medical history, an observation and evaluation of posture, stature, mobility, joints and organs, as well as tests for vision and hearing. In many elementary schools, a school physician is available to perform medical examinations, but most students are examined by their private physicians.

In most cases, a dental examination will also be necessary and will be performed by a dentist at another time.

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Reasons for a School Physical

There are many good reasons for a student to have a medical examination prior to attending school. All involve protecting individual children and their classmates. The doctor determines whether the student:

  • Has a contagious condition
  • Has a weight problem
  • Is growing at a normal rate
  • Needs glasses, a hearing aid, or other devices
  • Requires further diagnostic testing
  • Is up to date on immunizations
  • Needs special classroom accommodations
  • Requires medications during the school day

By performing a school physical, the doctor is able to evaluate the general health of the child or adolescent and to determine whether any further medical consultation is necessary.

Medical History

Taking a medical history is part of any thorough physical examination. The doctor will ask questions designed to protect the student from possible dangers during an average school day or during participation in sports or other exercise. The physician will make a note of any:

  • Congenital defects
  • Chronic disease conditions
  • Chest pain or shortness of breath
  • History of seizures
  • Previous surgical procedures
  • Prescription medications
  • Allergies
  • Previous injuries
  • Family history of medical problems

When the student is an adolescent, this portion of the school physical may also provide an opportunity to discuss matters of possible concern, such as smoking, drinking, drug use, sexual activity or depression.

The School Physical Procedure

During the course of the school physical, the doctor:

  • Records height and weight
  • Checks pulse and blood pressure
  • Evaluates posture, mobility, muscle strength
  • Checks heart, lung, and bowel function
  • Examines ears, nose, and throat
  • Administers vision and hearing tests

Depending on the state, the particular school, and the age of the student, other screenings may be performed, such as for lead or tuberculosis. If any immunizations are necessary, they may be administered during the school physical.

Sports Physicals

A sports physical exam, also known as a preparticipation physical examination (PPE), is a thorough medical examination that determines whether or not it is safe for an athlete to participate in a particular sport. The purpose of PPE is to prevent as many injuries and medical emergencies on the court or playing field as possible Sports physicals are often required for children and teens before they are allowed to join a team sport and are usually repeated before each season. PPEs are required by most state governments as well.

It is recommended that participants undergo sports physicals at least 6 weeks before the activity begins so there will be ample time if precautions or preparations are necessary.

Medical History

The first part of a sports physical involves the taking of a medical history. This is extremely important in terms of protecting the participant from possible danger during strenuous activity. The medical history includes information concerning:

  • Illnesses of family members
  • Chronic past disease conditions of the participant
  • Present health conditions
  • Prior hospitalizations or surgeries
  • Allergies, especially severe ones
  • Past musculoskeletal injuries or concussions
  • History of chest pain, breathing difficulties
  • History of dizziness or fainting
  • Medications (prescribed, OTC or supplemental)

This oral history is extremely important because awareness of possible underlying conditions, such as asthma or diabetes, may result in the physician prescribing particular treatments or recommending certain precautions, prior to exercise. It may also result in the physician prescribing medications for use if symptoms occur during exercise. In rare instances, the medical examination will make clear that participation in a particular sport is not recommended because of serious health risks.

Physical Examination

This examination is designed to detect any irregularities in the student’s physical condition that may be warning signs of a medical disorder. By checking vital signs and evaluating general health, the doctor can be confident in approving sports participation. During a sports physical, the doctor checks and records:

  • Height and weight
  • Pulse and blood pressure
  • Visual acuity and eye health
  • Ear, nose and throat condition
  • Heart, lungs and and bowel function
  • Posture, muscular strength, flexibility

During some physical examinations, an electrocardiogram (EKG) may be administered to further evaluate heart function or other diagnostic tests may be recommended.

Employment Physicals

Many employers require an employment physical to determine the suitability of an individual for a job. A pre-employment physical exam may be requested to ensure new hires are physically capable of performing their work and meet general health standards. Employment examinations may include physical examinations, health inquiries, psychological tests, drug testing, and mental health assessments. These exams compare the health of the potential employee with the expected demands of the job, to ensure that the individual is fit to do the job.

The goal of the employment physical is to determine whether or not the prospective employee is capable of performing the physical demands of the job. The physical also intends to enhance safety at the workplace, and minimize the risk of work site-related accidents. If a prospective employee has some physical issues that are not essential to the job, the employment physical also allows the employer to make proper accommodations for the employee.

Employment Physicals and Testing

Employment physical examinations are often regulatory and compliance examinations for:

  • Department of Transportation (DOT)
  • Occupational Safety and Health Administration (OSHA)
  • HazMat (Hazardous materials)

These physical examinations are often required by the federal government and employees must pass a medical evaluation conducted by a healthcare professional prior to employment. Additional employment examinations and tests include:

  • Pre-employment physicals
  • Drug and alcohol screening
  • Health risk assessments
  • Executive physicals

Fitness for duty examinations are also performed to medically evaluate the ability of a worker to return to duty after a medical leave. This examination can help to determine if the employee is fully able to perform the job or if any restrictions or accommodations may be necessary to protect the employee and employer.

The Employment Physical

Employment physicals may include exams tailored to the specific needs of a workplace. Prior to the examination, the patient’s complete medical and occupational histories are reviewed and the physical examination commonly includes the following:

  • Vision testing
  • Hearing test
  • Pulmonary function testing (PFT)
  • Blood pressure check
  • Height and weight check
  • Physical abilities tests (PATs)
  • Cardiovascular evaluation
  • Drug testing

Blood and urine tests are also administered. Some tests are tailored specifically to evaluate the physical requirements that are essential for the job.

A physical examination benefits both the potential employee and the employer. Employers are assured that the employee is physically fit for the job, and employees can be assured of safe and appropriate assignments in the workplace.