I do not get one. I have read the data, and do not see a reason for yearly screening. I had a physical at age 50 (and a colonoscopy) and plan to have another at age 60. I check my cholesterol every 3 or 4 years and my BP periodically.
I am healthy and have little significant family history.
Many physicians believe I should get a yearly physical despite the data – Tests on Healthy Patients Still Endorsed by Doctors
What good is evidence based medicine if we do not pay attention? Why even do the studies? I find these results a bit discouraging.
“Patients like tests,” said Dr. Prochazka, and the survey showed that physicians order them frequently. According to federal guidelines, the complete blood count, or C.B.C., is a test with no proven value for asymptomatic people. But the survey showed that 39 percent of physicians indicated that they would order one yearly.
Forty-four percent asked for urinalysis, 46 percent wanted blood glucose levels and 32 percent requested kidney function tests, even though none of these are recommended by the government as routine screening procedures.
On the other hand, 48 percent of doctors surveyed ordered a lipid panel, the screening test for cholesterol, which is recommended by the Preventive Services Task Force, an agency of the Department of Health and Human Services. Sixty percent also believed correctly that a Pap smear was recommended. The federal recommendations are all age and gender specific.
Unnecessary testing is not harmless, said Dr. Prochazka, who is a professor of medicine at the University of Colorado. “To the extent that one does a lot of testing that is not of proven value, it may actually detract from taking actions that are known to be beneficial,” he said.
An editorial accompanying the article contends that there still may be good reasons for annual exams, particularly because evidence suggests that a good relationship between doctor and patient is associated with adherence to treatment regimens.
Ninety-four percent of the doctors agreed that annual physicals helped improve the doctor-patient bond.
I did not do annual physicals on my patients, and yet I still believe that I had strong doctor-patient bonds. Old dogs like old tricks.
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{ 5 comments… read them below or add one }
I haven’t seen my family doctor in a couple of years, but I still think there’s a strong doctor-patient bond there. It depends on the doctor, but he’s a good one (patient, empathetic, explains things thoroughly without being condescending). I’ll be sad to move to a different doc when I move out of town.
Agree that “annual” physicals are unnecessary, but I do think that periodic visits are necessary. I do think that patient’s should have periodic “health screening” exams. The word “physical” is a misnomer, as most of what should be included does not involve a physical exam, but instead involves a thorough history, selected labs, and some counseling. There are evidence based periodic screenings (Pap smears, colon cancer screening, blood pressure checks, etc.) that should be done. I think the authors of the article should have clarified what they were talking about, “annual physical” does not equal “no need for preventive health screening”.
It does bother me that many physicians continue to routinely add unnecessary items to health screenings. My wife had UA at her last Pap, but there is no evidence for its use in a healthy 37 year old. Many physicians continue to check UA’s during high school physicals, despite many studies showing them to be unnecessary (even sports physicals are not supported by evidence, but I doubt many high schools would change their requirements for liability reasons).
The biggest concern I have with the article is that some would use it as a reason not to check things that there is good evidence for (BP, cholesterol, Paps, etc.). Like yourself I have also not had a physical, but I do have thinks checked periodically that are recommended. I have my cholesterol checked every 5 years, get my BP checked when I donate blood, & get an annual flu shot. I’ll get a colonoscopy when I hit my 40′s due to my family history, but I won’t bother with prostate cancer screening as I don’t think the evidence shows the risk outweighs the benefits.
Sadly every doctor I have seen in the last 20 years wants test. One doctor went as far as to tell me I was taking the food from his childrens mouths by not having six month physicals, with full blood screens.
I have been blessed with great health and would love the opportunity to just stop by and see my doctor to discuss my health issues. The reality is she, and others, view test as an income center and liability cover. Let’s hope more doctors take your enlightened view.
THe issue fundamentally is economic: Any diagnostic test offers the possibility of revealing a treatable disease, benefiting the patient. The best strategy is to invest time and money detecting those diseases which are likely and serious (and treatable) such as hypertension. The physical exam and UA are low yield ‘tests’ that should be accorded lower priority than blood pressure or cholesterol. Prioritizing should be driven by data. How far down to go on the list should be decided by whomever pays for the test. I had colonoscopy at 47, had adenomatous polyps, and will be back at 50. Payment comes out of my HSA.
Life starts to look a little different when you’re past 50. I don’t think I even HAD a regular doctor (internist or GP) until I was in my 40s, or knew where the local hospital was. A flu shot, a pap smear and mammo, and good to go.
With a family depending on me, however, and seeing the old bod starting to crumble eeeeever so slowly now that I’m on the shady side of 50, it seems only prudent to stay ahead of the curve and not wait till something ugly gets so ugly that it takes me down. Getting over a bad case of the flu takes a lot longer now than when I was 30. I need my job, I need to stay operative and mobile.
As noted above by other commenters, there are things that sneak up on you like hypertension and diabetes that you don’t want to find out you have shortly after your first stroke or coma. How to do that? Get some tests done regularly. Those of you who are doctors can do some self analysis as you go along and look into things that don’t feel quite right in your own bodies. The rest of us are passively waiting for you drs to suggest what to look for. I’m still trying to get somebody interested in giving me the pneumococcus injection, but no doctor ever runs down a check list and asks me if I’ve had it, and when I go into the office, my mind is on other stuff, like cramming my 15 questions into 3.5 minutes of the doctor’s laser-like focus.
Recent issue of Forbes talks about systematizing and checklisting medical procedure to be sure things are covered appropriately. Good idea: Proactive and not reactive medicine.