Do You Still Need an Annual Doctor’s Visit?
July 29, 2014 -- If it’s true that an apple a day keeps the doctor away, then it seems like seeing the doctor for an annual physical exam ought to play a major role in keeping healthy people healthy.
Yet most doctors now say it’s time to rethink the notion of a yearly physical, a fixture in U.S. medicine since the 1940s.
Possible Downsides of Yearly Checkups
Studies done over at least 30 years have shown that for healthy adults -- those who don’t have a long-term illness or take daily prescription medications -- annual wellness checks don’t lower the number of deaths. They also don’t cut the rates of disease-related deaths, hospitalizations, or the cost of care.
“There’s not a [ton] of evidence that going in annually, if you’re healthy, prevents bad things from happening,” says Thomas Miller, chief medical officer for the University of Utah’s Hospitals and Clinics.
Instead, studies from multiple researchers found the annual exams can lead to the overdiagnosis of some conditions, overtreatment, and to invasive, costly tests.
That’s exactly what happened to the 85-year-old father of Michael B. Rothberg, MD, MPH, a doctor at the Cleveland Clinic’s Center for Value-Based Care Research, Medicine Institute. Rothberg wrote about the experience last month in the Journal of the American Medical Association.
“The $50,000 Physical” describes the string of medical treatments ordered for his father after an annual physical identified a suspected aortic aneurysm. He didn’t have that, but a CT scan showed a lesion on his liver, which was suspected to be cancerous. A biopsy found Rothberg’s father had a single benign tumor, but he nearly bled to death from the biopsy.
And yet, as Rothberg says, the practice of annual checkups persists.
That’s in part because some doctor payments are tied to the practice, and also because patients have come to expect them each year. Data from a national 2010 survey found that 21% of medical visits were for preventive care. Having a general medical exam was the No. 2 reason people went to the doctor.
“It’s ingrained into our culture,” Miller says. “There’s a belief among some that it makes sense, so there’s always going to be a pool of folks who cherish the annual physical.”