In Defense of the Annual Checkup
Arguments against the time-honored practice are flawed, new research paper says
By Dennis Thompson
MONDAY, Jan. 4, 2016 (HealthDay News) -- Arguments urging doctors to abandon routine physical exams are based on insufficient evidence, a new research paper maintains.
The case against the regular checkup has been largely based on a review of 14 trials that concluded that annual visits do not reduce either illness or risk of death, according to the paper released online Jan. 4 in the Annals of Internal Medicine.
But the trials included in that review did not focus specifically on the value of the annual physical exam, and their results are being distorted, said paper lead author Dr. David Himmelstein, a professor at the City University of New York School of Public Health at Hunter College in New York City.
"There's been a lot of folks saying in public that there's no need for people to see their doctor regularly," Himmelstein said. "What we're saying is no, the studies don't say that. This is a misrepresentation."
The debate over the value of routine physicals has reached the point that the New England Journal of Medicine in October featured head-to-head editorials arguing for and against the time-honored practice.
Researchers questioning the worth of the regular checkup said that studies have failed to show any benefit from these periodic visits, which cost more than $10 billion a year in U.S. health care expenses.
Doctors would do better to use electronic health records to send alerts to people who need preventive measures such as an annual flu shot, detractors say. Patients could receive regular blood tests and other screening measures from nurses or physician assistants, saving doctors time to care for people with actual medical problems, the thinking goes.
"What does one mean by an annual physical?" said Dr. Allan Prochazka, co-writer of the NEJM piece questioning the checkup's usefulness. "From a patient perspective, it often means getting a variety of diagnostic tests. It is a common occurrence for a physician to do a detailed history, a relevant physical exam and preventive counseling, only to be asked, 'When do I get my physical?' -- meaning, when do I get the tests."