A health checkup refers to various examinations aimed at the early detection of diseases. In Germany, public health insurance plans cover the cost of this examination every three years for all insured individuals aged 35 and older. The examination is also known as the “Check-up 35.” Read more here about the procedure and the goals of the check-up, and find doctors who perform the check-up.
A health check-up is designed to detect common diseases at an early stage so that
These include
The incidence of these diseases increases starting at around age 35. For this reason, health insurance plans cover the cost of a basic check-up for everyone aged 35 and older every three years.
The health check-up is performed by primary care physicians (general practitioners, family physicians, and internists).
The health checkup consists of various components:
After the test results have been evaluated, a follow-up consultation takes place. During this consultation, the doctor informs the patient of the findings. If necessary, the doctor may also recommend further tests.
The health check-up aims to identify diseases that often do not cause any physical symptoms in their early stages. Therefore, even people who feel fit and physically healthy should undergo a health check-up.
Only through regular checkups can changes in the body be detected early and health risks averted. This allows suspected cases to be diagnosed more thoroughly through follow-up tests and identified conditions to be treated in a timely manner. This increases the chances of recovery.
In addition, unhealthy behaviors can be identified and modified through a check-up.
There are known risk factors for cardiovascular diseases, kidney diseases, and diabetes mellitus. These are assessed during the health check-up so that the patient can avoid them.
It is also recommended to combine the check-up with screening for the early detection of cancer. In this way, the check-up can also serve as cancer screening, for example, for skin cancer. However, other conditions that do not yet cause symptoms can also be detected through a check-up.
The health check-up can also assess your overall fitness and health status. Physical weaknesses are detected early on. They can then be successfully addressed at a younger age, before they lead to serious illnesses in later life.
The procedure for a check-up as part of statutory early detection and preventive care screenings is clearly regulated. First, there is a detailed consultation during which
are discussed to create a risk profile.
This is followed by a thorough physical examination as part of the health check-up. The physical examination includes
In addition, blood and urine samples are collected for laboratory analysis to determine the levels of
.
Since it may take several days to evaluate the results, a final consultation takes place during a second doctor’s appointment. The patient is informed of the results of the checkup. The doctor discusses with the patient the possible implications for their future lifestyle.
In particular, the patient’s risk profile and any potentially harmful health behaviors should be discussed.
The check-up may raise suspicion of a disease. In this case, the doctor will order further targeted diagnostic tests and, if necessary, initiate treatment.
Before beginning the physical examination, the doctor takes the patient’s medical history.
During this process, the doctor inquires about the patient’s past or current illnesses. The doctor also asks about previous health problems and surgeries. Illnesses that have occurred in close relatives are also discussed. Such illnesses include, for example,
The doctor will also ask about any medications the patient is currently taking.
An important part of the medical history is the patient’s individual lifestyle habits and living conditions. These include, for example,
By asking specific questions, the doctor tries to determine whether certain personal or hereditary risk factors are present.
After taking your medical history, the doctor will conduct a thorough physical examination as part of the health checkup. This includes
Weight and height are also measured so that the body mass index (BMI) can be calculated.
The body mass index (BMI) is a measure used to assess body weight. BMI is calculated based on the ratio of weight to height. The formula is:
BMI = (body weight in kg) divided by (height in m)².
BMI is a rather superficial measure, but it is helpful—with some caveats—for assessing whether a person is underweight or overweight.
During a health checkup, the doctor listens to the chest (heart and lungs) with a stethoscope. This examination is called auscultation.
The doctor listens for unusual breathing sounds or extrapulmonary sounds (rales and crackles) as well as heart sounds or heart murmurs.
This can help identify, for example,
.
The doctor measures the pulse rate (number of heartbeats per minute). In doing so, the doctor pays attention to both the quality (e.g., soft, weak) and the regularity of the pulse.
This allows for the identification of heart and vascular diseases, such as
Blood pressure is also measured; a reading of 140/90 mmHg or higher is considered high. Even at this early stage of high blood pressure, the risk of
is already increased.
A blood pressure measurement is part of the check-up © Robert Kneschke | AdobeStock
An ECG (electrocardiogram) is used when the doctor detects irregularities in the heart rhythm or other abnormalities. These can also include shortness of breath or chest pain.
The ECG records the electrical activity of the heart muscle. To do this, electrodes are attached to the skin. The ECG can be used to determine, among other things, heart rate and heart rhythm, and to read the electrical activity of the atria and ventricles.
For example, the ECG can provide evidence of
but may also indicate electrolyte imbalances and adverse drug reactions.
During the skin examination, the doctor looks for noticeable skin changes, such as
If the doctor identifies any unusual skin changes, the patient will be referred to a dermatologist for further evaluation.
In addition to physical examinations, several laboratory tests are also performed during the health checkup.
By measuring certain levels in the blood and urine, metabolic disorders (e.g., diabetes) or kidney diseases can be detected. This also allows the doctor to assess the risk of developing such diseases.
As part of the blood test, a blood sample is drawn from the patient and sent to a laboratory. This determines glucose levels (blood sugar) and total cholesterol levels.
To obtain accurate results that can be compared with standard reference ranges, the blood sample must be drawn in the morning on an empty stomach. This means the patient must not have eaten anything before the blood draw.
The results are usually available to the doctor within a few days. The measured blood sugar level should be between 60 and 100 mg/dl in capillary whole blood.
If it is higher than this, it may indicate diabetes mellitus. The doctor will then initiate more targeted diabetes testing. However, a value that is too low can also be an indication of a problem.
The total cholesterol level measured during the checkup should be between 200 and 220 mg/dl.
Higher levels may indicate an unhealthy diet or a lipid metabolism disorder. A total cholesterol level that is too high poses an increased risk of atherosclerosis. Atherosclerosis, in turn, can cause serious cardiovascular diseases such as heart attack and stroke.
Timely treatment of high blood lipid levels is therefore important.
Blood test results provide clues about possible health conditions © Henrik Dolle | AdobeStock
In addition to total cholesterol, your doctor can also have your LDL (“bad” cholesterol) and HDL (“good” cholesterol) levels tested. LDL should be below 160 mg/dl and HDL above 40 mg/dl.
However, the LDL-to-HDL ratio is also important: it should be less than three in a healthy person and even lower in high-risk patients.
As part of the check-up, the patient provides a urine sample, which is also sent to a laboratory.
The lab then determines the levels of
in the urine. These values provide the doctor with clues as to whether
is present.
The check-up provided as part of statutory early detection and preventive care programs is good but limited. In addition, an extended health check-up may be beneficial.
This is the case, for example, for people who want to resume physical activity after a long break. Additional tests can also be performed during the regular check-up to create an expanded, individualized risk profile. These include, for example,
A sports medicine fitness evaluation is recommended for all athletes over the age of 35 and for those returning to sports. The sports health check-up often consists of the following tests:
However, statutory health insurance plans do not cover the costs of an extended check-up. Doctors offer these check-ups as part of what are known as Individual Health Services (IGeL).
The final consultation will take place a few days after the physical examination and the collection of blood and urine samples.
The patient will be informed of the results of the check-up. If necessary, the doctor will discuss with the patient the potential implications for their future lifestyle. In particular,
. If necessary, the doctor will provide tips on lifestyle changes, such as regarding diet or exercise. Diabetes mellitus and cardiovascular diseases, in particular, can often be prevented through a healthy lifestyle. This includes, for example,
Another purpose of the final consultation following the check-up is to inform the patient about the importance of cancer screening tests.
If all test results are normal, the next check-up should take place in three years.
Every physician listed in the Leading Medicine Guide has attained the highest level of training and certification within their respective medical specialty society. Furthermore, we contacted this physician based, among other factors, on their case volume (surgeries, treatments, and therapies), which we determined by cross-referencing various publicly available sources. Following discussions with the selected physicians and the directors of the medical facilities, as well as a subsequent internal review, they were admitted to the Leading Medicine Guide.
The quality assurance of the Leading Medicine Guide is further ensured by 8 admission criteria. Each member must meet at least 6 of them:
