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There's No Evidence You Need an Annual Physical Exam, Say Doctors


For many people, going to the doctor for an annual physical exam ranks right up there with TSA airport screenings on the fun factor—we do it because we love living a healthy life more than we hate paper gowns, cold tables, and needles. Yet we may be subjecting ourselves to this yearly inconvenience unnecessarily, said Ateev Mehrotra, M.D., and Allan Prochazka, M.D., in an essay for the New England Journal of Medicine. (Find out how to Make the Most of Your Time at the Doctor's Office.)

The main issue the doctors have with the annual exam is that it's so poorly defined. Beyond getting weighed and having your heart listened to, what you get during your annual physical can run the gamut from a simple "you look fine" to a battery of expensive tests—and what you get is more likely to be dictated by what your insurance will cover than what's really in your best interest.

And annual exams don't seem to reduce the incidence of disease or death, according to recent research. One meta-study published in the British Medical Journal reported that there were no beneficial effects of general health checks on morbidity, hospitalization, disability, worry, additional physician visits, or absence from work. They also didn't see any reduction in heart disease or cancer, the two major killers of Americans.

Worse than being ineffective or inconvenient, the annual physical exam may actually be harmful, Mehrotra says, explaining that patients can be subjected to unnecessary testing, medications, and worry. "I just don't see any evidence for having every person see their doctor every year," he says, adding that canceling these appointments could save $10 billion in medical costs annually.

While it might sound good , not all doctors are on board with this idea. "There is a real benefit to annual physical," says Kristine Arthur, M.D., an internist at Orange Coast Memorial Medical Center in Fountain Valley, California. "The fear is that we'll lose this one point of contact with people who don't pay a lot of attention to their health and who don't normally come in to see a doctor." (Would You Facebook Chat Your Doctor?)

She does agree with Mehrotra on one thing: the confusion about what exactly a yearly exam is meant to do. "There's a misconception that this is a head-to-toe exam that will list all your problems," she says. "But really it's about one thing and one thing only—preventative health care." Done right, this can be very reassuring to patients, she adds, reducing their anxiety and giving them a sense of control over their health.

The idea is that people need regular screenings for colon cancer, cholesterol, blood pressure, and blood sugar and women also need regular pap smears and breast exams, Arthur explains, and it's helpful and convenient if they can get them in one place from one provider. "Call it whatever you want, but these things need to get done on a regular basis," she says. "Yet there's no need for redundant care—if you've seen your doctor a few times in the past year for other appointments and already done all of these things then you've essentially had your 'annual physical'," she says.

She concedes that an exam may not need to be done yearly if you're under 40 years old, have no chronic health conditions, are not on any medication, and don't have a family history of heart disease or cancer. In that case, she recommends a check-up every three years. However, she cautions that it's not enough to merely think you don't have any chronic health conditions—you need to have that confirmed by your doctor. "One of the best things a yearly check-up can do is catch a previously unknown chronic condition, like diabetes or heart disease, before it does real harm," she adds. (P.S. This App Compares Prescriptions for You with Advice from Real Doctors.)


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