Preventive Care in George

Cardiovascular disease and diabetes are the principal causes of death and long-term disability among South African adults. The South African Medical Research Council estimates that over half of these cases would be detected earlier, treated cheaper, and prevented from progressing if patients had a routine annual screening.

Preventive medicine is unglamorous. It rarely diagnoses anything dramatic. The point is that small changes caught early (a creeping blood pressure number, a borderline HbA1c, an early breast lump, a slowly worsening lung function reading on spirometry) compound into major health events when missed for years. The annual visit exists to catch them before they compound.

NeoHealth treats preventive care as primary care, not a lifestyle product. The screening you need is determined by your age, sex, family history, and risk profile, not by a marketing package.

Most major South African schemes pay for one preventive care or wellness screening visit per member per year, separately from your day-to-day savings or hospital plan. The benefit usually includes the consultation, the standard preventive bloods, and basic in-room tests (urinalysis, ECG, BP, BMI, waist circumference). NeoHealth is a registered provider for:

• GEMS: annual wellness screening
• Polmed: preventive care benefit
• Bonitas: preventive care benefit
• Discovery: Vitality Health Check
• Medscheme-administered schemes: preventive care benefit

If your scheme is not listed, your benefit booklet almost certainly includes a similar provision. Bring your scheme card and we will check what is covered before billing. Self-paying / cash patients pay our standard consultation fee plus pathology if any out-of-rooms tests are sent.

The visit is structured around four risk domains: cardiovascular, metabolic, cancer-relevant, and mental health. Most patients are in and out in 30 to 45 minutes, with results returning over the following week.

The components above stay roughly the same. What changes is the priority and frequency.

GPs are the first line for the four cancers we routinely screen for in South African primary care.

Cervical: every 3 to 5 years between ages 21 and 65, with HPV co-testing where appropriate. Done in-rooms with Dr Lakay. The cervical screening article covers the procedure, what to expect, and how often.

Breast: annual breast exam from age 40, with mammogram every 1 to 2 years from 40 to 50 onwards depending on personal and family risk. We coordinate referral to a breast imaging service in George.

Colorectal: faecal immunochemical testing (FIT) every 1 to 2 years from age 45 to 50, with colonoscopy referral for positive results or strong family history. Colonoscopy is the gold-standard but FIT is the realistic primary-care first line for most patients.

Prostate: prostate-specific antigen testing is a discussion, not a default. Benefits and limitations are real. We talk through them with male patients from age 50 (or 45 with family history) and decide together whether to screen.

Skin: annual visual mole and lesion check is part of every preventive visit, with dermatoscopy in-rooms when indicated and referral when a lesion is suspicious. Skin lesion removal is a same-rooms procedure where appropriate.

Most chronic disease prevention happens outside the consulting room, but the consulting room is where the conversation starts. The annual visit covers:

• Smoking: cessation support, including nicotine replacement therapy and varenicline prescription where indicated
• Alcohol: brief intervention if intake is above the South African Medical Association lower-risk thresholds (14 units per week for men, 7 units per week for women)
• Exercise: the World Health Organization recommends 150 minutes of moderate activity or 75 minutes of vigorous activity per week, plus two strength sessions. Most adults do not hit this and do not know what counts
• Diet: Mediterranean and DASH dietary patterns have the strongest evidence for cardiovascular and metabolic health. We talk through realistic adjustments rather than handing out diet sheets
• Sleep: screening for insomnia, sleep apnoea risk in patients with relevant features, and the cardiovascular implications of chronic short sleep
• Stress and mood: mental health screening as above, with referral or follow-up consultation when indicated

• Fast for 8 to 12 hours before your appointment if your scheme benefit includes lipid and glucose bloods. Water is fine. Take routine medication unless your prescribing doctor has said otherwise
• Bring your medical aid card, your ID, and a list of current medications including over-the-counter and supplements
• Know your immediate family medical history at a basic level: parents, siblings, grandparents, what they had and at what age. This shapes your risk assessment substantially
• Wear something that allows easy BP cuff placement on your upper arm and ECG lead placement if needed
• Block 45 minutes for the visit. Most are done in 30 but the bloodwork and ECG add time

Patients often combine the preventive screening with:

• Vaccine catch-ups for adults: seasonal flu (Influvac), tetanus boosters, and Hepatitis B vaccine for the SA-registered indications (see our vaccinations service page for the full scope)
• Skin checks and minor lesion removal when something is flagged during the visit
• Chronic disease review for patients on existing scripts
• IV vitamin therapy (with Dr Lakay, FPD-certified IV Therapy) for patients who would benefit clinically

For a more comprehensive screening beyond what the standard scheme benefit covers, see the NeoHealth Check, our extended annual screening package on Saturdays.