Annual school physicals are a mainstay in the healthcare of children.  The goal of a school physical is to promote health, detect disease and to counsel children and parents in the hopes of preventing future injuries and health problems.  More recently these physicals have been offered by schools in a group fashion where student athletes are rotated through different areas which assess vision, joints, blood pressure, pulse and a physical exam is done by a physician.  These types of physicals do screen large amounts of children. However, concerns arise on how thoroughly these children are being screened and, more importantly, counseled in this setting.

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The American Academy of Family Physicians recommend that a child’s physical exam consist of addressing diet, physical activity, daily screen time, hours of sleep, dental care, school performance, and safety habits. Certain aged children should also be screened for depression, obesity, hypertension and vision and hearing. The average child spends 7.5 hours per day in front of a screen and the recommended time is less than one hour per day. Most children sleep about 9.4 hours per night however the ideal amount in this age group is 11 hours per night.  24% of children younger than 13 have had their first drink and 15% have smoked an entire cigarette with 8% having tried marijuana and 7% being sexually active. Therefore, it is recommended that these specific topics be discussed beginning at 11 years of age, preferably without the parent in the room. Accidental injuries are the leading cause of death for school aged children and falls are the leading cause of nonfatal injuries. Outpatient counseling has been shown to decrease injury rates in children. 

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While group physicals done at schools are convenient  and do screen large numbers of children one must decide if this type of physical is adequate for your child and accomplishes the goals of keeping your child healthy and safe.

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