Feeling guilty because you're overdue for your annual physical exam? You might rethink those feelings since recent research found that a regular general medical checkup failed to demonstrate any meaningful benefits on the incidence of serious disease, disability, anxiety, rates of hospitalization, the need for additional physician visits or days absent from work.
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So are physical exams worth your time at all? On one hand, some studies have found that checkups increase the detection and treatment of high blood pressure and high cholesterol and that patients who are regularly examined report an overall beneficial effect on their health -- although the effect is small.
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Also noteworthy: The trials that found little to no benefit on overall health outcomes followed patients for only an average of five years or less, so it's possible that the health benefits from early screening and detection might not have had time to surface.
So should you get an annual checkup or not? The answer -- like many things in medicine -- isn't simple, but here are some things to keep in mind when deciding:
"One size fits all" doesn't apply to the general checkup. Your provider should tailor the visit to you, concentrating on important lifestyle interventions, vaccinations and, when necessary, testing that makes sense in the context of your particular circumstances.
There's no need to run blood tests just to "see what pops up." The most recent guidelines for sensible screening and testing, which are continually being reevaluated by health experts, can serve as a starting point for limiting unnecessary tests and focusing only on those that have a high likelihood of making a difference in your health.
Overtesting can lead to overdiagnosis -- the detection of "abnormalities" that will never affect your health, but once uncovered lead to further testing and sometimes even invasive procedures like biopsies that are expensive and carry their own very real risks of harm.
If you're young and healthy, it's your call. For relatively young, healthy individuals, there's no need to insist on an annual physical exam. But any practice that fosters a close relationship between you and your health care provider is likely to be a good thing. For some people that may mean an annual visit, for others it might mean seeing their provider every two or three years or only when concerns arise. The need for certain screening tests (e.g., mammography, cervical cancer screening, colon cancer screening) and adhering to well-vetted vaccination schedules may help you figure out the recommended interval between visits.
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Older adults are more likely to benefit. Most of the studies that have found little to no benefit from an annual exam focused on people under the age of 65. If you're 65 or older, you're more likely to benefit from regular wellness visits to screen for chronic illnesses that may not be apparent, such as diabetes, heart disease, depression and even some cancers.
A good general exam should include a comprehensive medical history, family history, lifestyle review, problem-focused physical exam, appropriate screening and diagnostic tests and vaccinations, with time for discussion, assessment and education. And a good health care provider will always focus first and foremost on your health goals.
These may vary from "I want to live as long as possible" to "I want to enjoy a high quality of life for as long as possible," and you may define "quality" differently from the next patient. The best health care is delivered when you develop an informed and communicative partnership with your health care provider.
Readers -- Do you get an annual checkup? If not, why? Do you think blood tests, exams, etc. are necessary if you're generally healthy? Leave a comment below and let us know.
Malcolm Thaler, M.D., is a physician at One Medical Group. He enjoys being on the front lines of patient care and managing diagnostic and therapeutic challenges with a compassionate, integrative approach that stresses close doctor-patient collaboration. He is the author and chief editor of several best-selling medical textbooks and online resources and has extensive expertise in managing a wide range of issues, including the prevention and treatment of cardiovascular disease, diabetes and sports injuries.