What is your doctor thinking?

Your well-check appointments

Interview with Steven Von Elten, M.D., Piedmont Family Practice

Steven Von Elten, M.D., of Piedmont Family Practice in Warrenton, says, “When patients come in for a visit, my first question is always, ‘How are you doing?’, and I wait for the answer. If they hesitate and take a deep breath, that tells me something’s going on. I watch how they act, if they’re stressed. Then I’ll figure out what’s going on and address it.” 

Your family doctor is there for you through your entire life, and will cover not just physical health, but overall life quality and safety. He or she can do so more effectively if you keep your regular well-check physical appointments and a good relationship is developed.

Check-ins with your doctor for infants and babies are crucial for vaccinations and making sure developmental milestones are being reached. But as children grow and remain healthy, sometimes they see the doctor only when they’re sick. But it’s important to continue the well visits for the child to get comfortable in the office environment and start forming that lifelong relationship with their physician.   

In addition to physical health, the physician will also be monitoring children’s intellectual development, and assessing how they are getting along socially with their peers, siblings and parents. For pre-teens and teens, doctors want to make sure that parents are having conversations about puberty, what to expect and how things will change. This may also be a time to start addressing peer pressure, drugs, alcohol, and safe driving. “I try to tell those young teens, in my career, knock on wood, I haven’t lost any teens due to illness; sadly, I’ve lost them to driving and alcohol,” says Dr. Von Elten. These conversations continue through young adulthood as college approaches, and your doctor will continue to monitor your life quality and stress levels through adulthood. With seniors, doctors watch for lifestyle issues as well as physical health, assessing their memory, balance, falling incidents, and home safety. 

Dr. Von Elten explains, “In the end, ultimately what happens to our health and longevity is the result of three things: a healthy lifestyle (not smoking, not abusing drugs or alcohol, exercising, eating right), your genetics and family history of illness, and the last, what we call AoG: Act of God, something that is just out of the blue and something we can’t control. But I notice that people who in general live the longest have learned to develop a sense of humor. Stress is a human condition that cannot be avoided and can be very very destructive to your health. Those who have learned to use humor to cope with stressful situations can handle adversity more effectively, which has a positive effect on their health.” 


Vaccines help us stay healthy by preventing disease and boosting our immune system. It is tragic to see a patient become gravely ill or die for lack of receiving a vaccination.

Infancy and childhood

Vaccinations start with Hepatitis B as an infant in the hospital, and continue through vaccination series at two months and when entering preschool. Their last childhood shot series including Tdap will be when entering the sixth grade. At this time girls will be offered the HPV vaccine to prevent cervical cancer. 

Young adult

Meningococcal vaccine to prevent meningitis at college physical, required by most schools. 

Through all life stages:

Flu shots every year, starting at 6 months. 

Tdap (tetanus, diphtheria, and whooping cough): every 8-10 years OR after a “tetanus prone” injury. 

Td (tetanus/diphtheria) after the age of 65; if around children or infants the Tdap is necessary for whooping cough.  

Shingles vaccine two-shot series at age 60 

Consult your doctor if you are traveling overseas for recommended additional vaccines. 

Well Check Physicals

Infants and children: Delivery, 3-7 days post-delivery, then at the age of 1 month, then every 2 months through age 6 months, then quarterly through age 24 months, then annually through the age of 6 years  

Young adults: every 5 years

Middle age: your recommended schedule will be determined by your doctor based on your health

Seniors 65+: yearly, as recommended by Medicare

Recommended screenings:


Pelvic exam and pap smear starting at 21 unless they are sexually active, and continuing every 3 years through lifetime if results remain normal

Mammograms annually, starting at 45-54 depending on risk level


Prostate screening starting at age 40-50 depending on risk level.  The ongoing frequency will depend on risk level


Colonoscopy starting at 50, then frequency depending on risk level.

EKG at age 40, subsequent frequency on risk level

Pam Kamphuis
About Pam Kamphuis 142 Articles
Pam Kamphuis is an editor and writer for Piedmont Virginian Magazine and Piedmont Lifestyle Magazines.

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