Primary Care in Charleston and Mt. Pleasant, SC

Reviewed by Ashley Harwyn, PA-C, ABAAHP  |  A4M Board Certified  |  Updated October 4, 2026

A preventive visit should be built on the screenings that have earned their place, not on every test available. Here is what that list looks like, and how we use it.

That surprises people. When researchers pooled randomized trials of general health checks, where adults without symptoms were screened for many conditions at once, the checks made little or no difference to how many people died.[7] The services with solid evidence are specific ones: blood pressure checks, colon cancer screening, cervical screening, and the other items the US Preventive Services Task Force grades A or B.[1] So we build your visit around those, explain why each one is there, and add deeper work such as annual full panel labs only when there is a clear reason.

• The US Preventive Services Task Force gives an A or B grade to services with a high or moderate net benefit, and those form the backbone of a preventive visit.[1]
• Every adult 18 and older should have blood pressure screened, and a high office reading should be confirmed outside the office before treatment starts.[1]
• Colon cancer screening starts at 45. A stool DNA test such as Cologuard is one option every 1 to 3 years, and any abnormal stool test needs a follow-up colonoscopy.[2]
• Women 40 to 74 should have a mammogram every 2 years. Thermography is not a substitute, and the FDA has said so directly.[1][4]
• For men 55 to 69, a PSA test for prostate cancer is a personal decision to make after a real conversation, not an automatic add-on.[3]
• Trials of broad health checks in people without symptoms found little or no effect on deaths, which is why we test with a purpose.[7]

What happens at a preventive visit

A preventive visit has three jobs: find problems early that are worth finding, lower your risk of the big ones (heart disease, stroke, diabetes, and common cancers), and keep your vaccines current. Ashley starts with your story: your family history, medications, sleep, stress, alcohol and tobacco use, and what has changed since your last visit. Then comes the exam itself, including a blood pressure reading, which the Task Force recommends for every adult 18 and older.[1]

Some of the most useful parts of the visit are questions, not lab draws. The Task Force recommends screening all adults for depression, adults 64 and younger for anxiety, and adults 18 and older for unhealthy alcohol use.[1] It also recommends that clinicians ask every adult about tobacco, advise quitting, and offer real help to do it.[1] None of this needs a needle, yet all of it can change the plan. If mood comes up, we can connect you with mental health care rather than treat it as a footnote.

Vaccines round out the visit. The CDC adult schedule lists a flu shot once a year, a Td or Tdap booster every 10 years after one Tdap dose, and a two-dose shingles series starting at 50.[5] The American Academy of Family Physicians also keeps its own adult schedule, updated for 2026 with clearer guidance in what it calls rapidly evolving areas.[6] So we check the current recommendations at your visit and talk through any you are unsure about.

Which screenings you need, and when

Your age and your risk set most of the plan. Here is the core of the Task Force A and B list for adults who are not pregnant. A grade of A or B means the Task Force found a high or moderate net benefit.[1]

The statin row is the one people misread. It is not a rule that everyone over 40 takes a statin. It applies to adults 40 to 75 who have at least one risk factor, such as abnormal cholesterol, diabetes, high blood pressure, or smoking, and whose estimated 10-year risk of a cardiovascular event is 10% or higher.[1] Getting to that estimate takes real numbers, which is where lipid testing and a look at your heart health come in.

Colon screening has more choices than most people realize. The Task Force lists a yearly FIT stool test, a stool DNA test with a FIT part every 1 to 3 years, CT colonography or flexible sigmoidoscopy every 5 years, and colonoscopy every 10 years, among other options.[2] Cologuard is a stool DNA test of this kind. The catch: if any stool test comes back abnormal, you need a colonoscopy to finish the job.[2] After 75, screening becomes a case-by-case choice rather than a default.[2]

For cervical screening, Ashley does Pap smears in the office. For mammograms, colonoscopy, Cologuard kits, and DEXA bone density scans, we help you arrange them. If you meet the lung cancer criteria in the table, say so at your visit, because the smoking history that qualifies you is easy to leave out of a busy appointment.

Why more testing is not the same as better care

Testing for everything feels safer. The research disagrees. A 2019 Cochrane review pooled randomized trials of general health checks, meaning screening for many diseases or risk factors at once in adults who were not sick. Across 15 trials with outcome data and more than 250,000 people, the checks had little or no effect on deaths from any cause or from cancer, and probably little or no effect on deaths from heart disease.[7] The reviewers concluded that general health checks are unlikely to help.[7]

Why would extra testing fail to help? Part of the answer, as the same review notes, is that screening leads to more tests and more treatment, and those can cause harm as well as good.[7] So we pick tests that answer a real question for you, not ones that simply produce more numbers.

Prostate cancer screening is a good example of a test that needs a conversation first. For men 55 to 69, the Task Force says the choice to have a PSA test should be an individual one, and it recommends against PSA screening at 70 and older.[3] That 2018 guidance is being updated.[3] A false-positive result can lead to more testing and possibly a biopsy.[3] Ashley offers prostate screening and will talk that through with you before you decide.

Thermography is a clear case of a test sold beyond its evidence. The FDA has said thermography has not been shown to work as a standalone breast cancer screening test, that the devices are cleared only as an add-on to a primary test like mammography, and that it knows of no scientific evidence that thermography can replace a mammogram.[4] If you are curious about thermography, which we can help arrange, treat it as an extra on top of your mammogram, never a replacement for it.

Where specialty labs fit

Solcara also runs a number of tests in the office. Some sit firmly inside standard care: advanced lipid testing, comprehensive blood panels, STD testing, Pap smears, and fertility labs. Others are tools for specific questions, such as InBody body composition and urinary menstrual mapping. The useful question for any of them is the same: what decision will this result change?

Then there is a group of specialty tests that people often ask for by name: neurotransmitter panels, DUTCH hormone metabolite testing, salivary adrenal panels, and gut health mapping. Ashley offers these, but you should know where they stand. None of them is a validated screening test, and none appears on the Task Force A and B list.[1] Their validation is limited, so they do not replace the core screenings above, and they should never be the reason a colonoscopy or mammogram slips. We have written plainly about the limits on our neurotransmitter testing and cortisol testing pages.

At best, a specialty test answers a narrow question the standard workup left open. Ashley will tell you whether yours is that kind of question before anything is ordered.

Lost track of which screenings are due? Most adults have. Call 843-981-0870 to book a preventive visit, and Ashley will sort out what you need now, what can wait, and what you can safely skip.

Seeing Ashley: time, continuity, and follow-through

Solcara is a concierge practice, and in plain terms that means the visit is built around time with one clinician. You see Ashley Harwyn, PA-C, who is board certified in anti-aging and functional medicine through the A4M and holds the ABAAHP credential. Because the same person sees you visit after visit, your history does not have to be retold, and a small change in your numbers from one year to the next is easier to catch.

Primary care here runs alongside our functional medicine work, not in place of it. The evidence-based basics come first, and deeper work, such as thyroid care, is added when your history points there. An abnormal result should always come with a named next step.

You can see Ashley in Mount Pleasant at 496 Bramson Ct, Suite 120, or downtown at The Longevity Club, 163 Rutledge Ave, Suite 202. Bring your last lab results, your medications and supplements, and the dates of any past screenings you remember.