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You’re in a doctor’s office with a clipboard and a pile of medical forms on your lap. For the umpteenth time, you must now jot down your medical history — conditions, ongoing symptoms, past procedures, current medications, and even the health of family members.

But how much information should you include? Which details are most important? And why are you slogging through paper forms when a digital version likely exists? Put down your pen for a moment and take a breath. We have some answers.

Do you actually need to fill out the forms again?

In many cases, you do need to fill out medical history forms. That can be true even if you already have a digital record on file, known as an electronic medical record (EMR) or electronic health record (EHR).

The reason for collecting new information could be due to a variety of reasons:

• The health care provider might want an update, since information like medications or new health problems can change over time, or you might have missing or inaccurate information in your record.
• Different specialists need to know about different aspects of your health.
• Your EMR at one provider’s office might not be accessible to others because practices don’t always have compatible computer software.
• Some practices don’t want to rely on records created by other practices. They may not trust that they’re accurate.

What if you don’t want to fill out the forms?

“You don’t have to,” says Dr. Robert Shmerling, a rheumatologist and senior faculty editor at Harvard Health Publishing. “But the response from the practice might be, ‘How can we provide the best care if you don't provide the information?’ And if you persist, you run the risk of marking yourself — unfairly, perhaps — as uncooperative.”

What are the most important details in your medical history?

The most important details of your medical history include

• chronic or new symptoms and conditions
• past surgeries
• family medical history
• insurance information
• current prescription and over-the counter medicines, supplements, vitamins, and any herbal remedies or complementary medicines you use
• medication allergies
• vaccination history
• any screening tests you’ve had, so they won’t be prescribed unnecessarily
• any metal implants you have, which could affect screenings.

If you don’t know all of the details, try to get them from a previous doctor or hospital you’ve visited.

“In some cases, not having the information could be a problem. For example, I need to know if my patients have had certain vaccines or if they have medication allergies,” says Dr. Suzanne Salamon, associate chief of gerontology at Harvard-affiliated Beth Israel Deaconess Medical Center.

Which information might be less important?

Sometimes, leaving out certain details might not matter, depending on the purpose of your health visit. For example, your eye doctor doesn’t need to know that you broke your wrist when you were 18, had the flu last year, or had three C-sections. But they should know which medicines and supplements you take, and whether you have certain health conditions such as diabetes or high blood pressure.

Not sure what to leave in or out of your history? Dr. Salamon suggests that you at least focus on the big stuff: chronic symptoms and conditions that need ongoing treatment, medications and supplements you’re taking, and your family medical history.

“If you can, bring a copy of your medical history to all new doctor appointments. It could be written or printed from your patient portal or kept handy on a digital health app. That way, you’ll have it handy if you need to fill out medical forms or if the physician asks you questions about your medical history during an appointment,” Dr. Salamon advises.

How secure is the information you’re providing?

We trust health care professionals with our lives and our most private information, including our social security numbers (SSNs). SSNs are used to double-check your identity to avoid medical errors, and to make sure your insurance information is accurate and practices get paid.

Is it really safe to hand over the information? It’s supposed to be. A federal law called the Health Insurance Portability and Accountability Act (HIPAA) protects your health information with very strict rules about who can access it and how it can be shared.

“Medical practices take this very seriously,” Dr. Shmerling says. “They have lots of safeguards around personal health information, and routinely warn medical staff about not looking at or sharing information inappropriately — with the threat of being fired immediately if they do. Electronic health records usually track those who look at our information, so it's often not hard to enforce this.”

But no hospital or other entity can guarantee that your information is protected. That’s true of all information, especially with the constant threat of cyberattacks.

“So if you feel strongly about it, you can try saying that you’d rather not provide certain information and ask whether the practice can explain why it’s necessary,” Dr. Shmerling says. “It takes a certain amount of trust in the system that personal health information will be kept private, even though that may feel like taking a leap of faith.”

About the Author

Heidi Godman, Executive Editor, Harvard Health Letter

Heidi Godman is the executive editor of the Harvard Health Letter. Before coming to the Health Letter, she was an award-winning television news anchor and medical reporter for 25 years. Heidi was named a journalism fellow … See Full Bio View all posts by Heidi Godman

About the Reviewer

Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing

Dr. Howard LeWine is a practicing internist at Brigham and Women’s Hospital in Boston, Chief Medical Editor at Harvard Health Publishing, and editor in chief of Harvard Men’s Health Watch. See Full Bio View all posts by Howard E. LeWine, MD

By the time boys are 8 or 10, they’re steeped in Marvel action heroes with bulging, oversized muscles and rock-hard abs. By adolescence, they’re deluged with social media streams of bulked-up male bodies.

The underlying messages about power and worth prompt many boys to worry and wonder about how to measure up. Sometimes, negative thoughts and concerns even interfere with daily life, a mental health issue known body dysmorphic disorder, or body dysmorphia. The most common form of this in boys is muscle dysmorphia.

What is muscle dysmorphia?

Muscle dysmorphia is marked by preoccupation with a muscular and lean physique. While the more extreme behaviors that define this disorder appear only in a small percentage of boys and young men, it may color the mindset of many more.

Nearly a quarter of boys and young men engage in some type of muscle-building behaviors. “About 60% of young boys in the United States mention changing their diet to become more muscular,” says Dr. Gabriela Vargas, director of the Young Men’s Health website at Boston Children’s Hospital. “While that may not meet the diagnostic criteria of muscle dysmorphia disorder, it’s impacting a lot of young men.”

“There’s a social norm that equates muscularity with masculinity,” Dr. Vargas adds. “Even Halloween costumes for 4- and 5-year-old boys now have padding for six-pack abs. There’s constant messaging that this is what their bodies should look like.”

Does body dysmorphic disorder differ in boys and girls?

Long believed to be the domain of girls, body dysmorphia can take the form of eating disorders such as anorexia or bulimia. Technically, muscle dysmorphia is not an eating disorder. But it is far more pervasive in males — and insidious.

“The common notion is that body dysmorphia just affects girls and isn’t a male issue,” Dr. Vargas says. “Because of that, these unhealthy behaviors in boys often go overlooked.”

What are the signs of body dysmorphia in boys?

Parents may have a tough time discerning whether their son is merely being a teen or veering into dangerous territory. Dr. Vargas advises parents to look for these red flags:

• Marked change in physical routines, such as going from working out once a day to spending hours working out every day.
• Following regimented workouts or meals, including limiting the foods they’re eating or concentrating heavily on high-protein options.
• Disrupting normal activities, such as spending time with friends, to work out instead.
• Obsessively taking photos of their muscles or abdomen to track “improvement.”
• Weighing himself multiple times a day.
• Dressing to highlight a more muscular physique, or wearing baggier clothes to hide their physique because they don’t think it’s good enough.

“Nearly everyone has been on a diet,” Dr. Vargas says. “The difference with this is persistence — they don’t just try it for a week and then decide it’s not for them. These boys are doing this for weeks to months, and they’re not flexible in changing their behaviors.”

What are the health dangers of muscle dysmorphia in boys?

Extreme behaviors can pose physical and mental health risks.

For example, unregulated protein powders and supplements boys turn to in hopes of quickly bulking up muscles may be adulterated with stimulants or even anabolic steroids. “With that comes an increased risk of stroke, heart palpitations, high blood pressure, and liver injury,” notes Dr. Vargas.

Some boys also attempt to gain muscle through a “bulk and cut” regimen, with periods of rapid weight gain followed by periods of extreme calorie limitation. This can affect long-term muscle and bone development and lead to irregular heartbeat and lower testosterone levels.

“Even in a best-case scenario, eating too much protein can lead to a lot of intestinal distress, such as diarrhea, or to kidney injury, since our kidneys are not meant to filter out excessive amounts of protein,” Dr. Vargas says.

The psychological fallout can also be dramatic. Depression and suicidal thoughts are more common in people who are malnourished, which may occur when boys drastically cut calories or neglect entire food groups. Additionally, as they try to achieve unrealistic ideals, they may constantly feel like they’re not good enough.

How can parents encourage a healthy body image in boys?

These tips can help:

• Gather for family meals. Schedules can be tricky. Yet considerable research shows physical and mental health benefits flow from sitting down together for meals, including a greater likelihood of children being an appropriate weight for their body type.
• Don’t comment on body shape or size. “It’s a lot easier said than done, but this means your own body, your child’s, or others in the community,” says Dr. Vargas.
• Frame nutrition and exercise as meaningful for health. When you talk with your son about what you eat or your exercise routine, don’t tie hoped-for results to body shape or size.
• Communicate openly. “If your son says he wants to exercise more or increase his protein intake, ask why — for his overall health, or a specific body ideal?”
• Don’t buy protein supplements. It’s harder for boys to obtain them when parents won’t allow them in the house. “One alternative is to talk with your son’s primary care doctor or a dietitian, who can be a great resource on how to get protein through regular foods,” Dr. Vargas says.

About the Author

Maureen Salamon, Executive Editor, Harvard Women's Health Watch

Maureen Salamon is executive editor of Harvard Women’s Health Watch. She began her career as a newspaper reporter and later covered health and medicine for a wide variety of websites, magazines, and hospitals. Her work has … See Full Bio View all posts by Maureen Salamon

About the Reviewer

Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing

Dr. Howard LeWine is a practicing internist at Brigham and Women’s Hospital in Boston, Chief Medical Editor at Harvard Health Publishing, and editor in chief of Harvard Men’s Health Watch. See Full Bio View all posts by Howard E. LeWine, MD

As wildfires become more frequent due to climate change and drier conditions, more of us and more of our communities are at risk for harm. Here is information to help you prepare and protect yourself and your family.

How does wildfire smoke affect air quality?

Wildfire smoke contributes greatly to poor air quality. Just like fossil fuel pollution from burning coal, oil, and gas, wildfires create hazardous gases and tiny particles of varying sizes (known as particulate matter, or PM10, PM2.5, PM0.1) that are harmful to breathe. Wildfire smoke also contains other toxins that come from burning buildings and chemical storage.

The smoke can travel to distant regions, carried by weather patterns and jet streams.

How does wildfire smoke affect our health?

The small particles in wildfire smoke are the most worrisome to our health. When we breathe them in, these particles can travel deep into the lungs and sometimes into the bloodstream.

The health effects of wildfire smoke include eye irritation, coughing, wheezing, and difficulty breathing. The smoke may also increase risk for respiratory infections like COVID-19. Other possible serious health effects include heart failure, heart attacks, and strokes.

Who needs to be especially careful?

Those most at risk from wildfire smoke include children, older adults, outdoor workers, and anyone who is pregnant or who has heart or lung conditions.

If you have a chronic health condition, talk to your doctor about how the smoke might affect you. Find out what symptoms should prompt medical attention or adjustment of your medications. This is especially important if you have lung problems or heart problems.

What can you do to prepare for wildfire emergencies?

If you live in an area threatened by wildfires, or where heat and dry conditions make them more likely to occur:

• Create an evacuation plan for your family before a wildfire occurs.
• Make sure that you have several days on hand of medications, water, and food that doesn't need to be cooked. This will help if you need to leave suddenly due to a wildfire or another natural disaster.
• Regularly check this fire and smoke map, which shows current wildfire conditions and has links to state advisories.
• Follow alerts from local officials if you are in the region of an active fire.

What steps can you take to lower health risks during poor air quality days?

These six tips can help you stay healthy during wildfire smoke advisories and at other times when air quality is poor:

• Stay aware of air quality. AirNow.gov shares real-time air quality risk category for your area accompanied by activity guidance. When recommended, stay indoors, close doors, windows, and any outdoor air intake vents.
• Consider buying an air purifier. This is also important even when there are no regional wildfires if you live in a building that is in poor condition. See my prior post for tips about pollution and air purifiers. The EPA recommends avoiding air cleaners that generate ozone, which is also a pollutant.
• Understand your HVAC system if you have one. The quality and cleanliness of your filters counts, so choose high-efficiency filters if possible, and replace these as needed. It's also important to know if your system has outdoor air intake vents.
• Avoid creating indoor pollution. That means no smoking, no vacuuming, and no burning of products like candles or incense. Avoid frying foods or using gas stoves, especially if your stove is not well ventilated.
• Make a "clean room." Choose a room with fewer doors and windows. Run an air purifier that is the appropriate size for this room, especially if you are not using central AC to keep cool.
• Minimize outdoor time and wear a mask outside. Again, ensuring that you have several days of medications and food that doesn't need to be cooked will help. If you must go outdoors, minimize time and level of activity. A well-fitted N95 or KN95 mask or P100 respirator can help keep you from breathing in small particles floating in smoky air (note: automatic PDF download).

About the Author

Wynne Armand, MD, Contributor

Dr. Wynne Armand is a physician at Massachusetts General Hospital (MGH), where she provides primary care; an assistant professor in medicine at Harvard Medical School; and associate director of the MGH Center for the Environment and … See Full Bio View all posts by Wynne Armand, MD