Are Annual Physicals Necessary?

Earlier this year, New York Times physician reporter Elisabeth Rosenthal wrote a controversial cover article for the Sunday Review titled “Let’s Not Get Physicals.” In it, she argued that yearly physicals are largely meaningless and may be dangerous because many routine tests performed during physicals lead to unnecessary biopsies and other costly additional tests.

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Are annual physicals that essential to maintaining good health?

As you’d imagine, the Sunday Review’s comments section lit up with people taking both sides, swearing that an annual physical caught an important heath issue or testifying that physicals every three years were more than enough.

As Rosenthal pointed out, she wasn’t suggesting that people put off health screenings as indicated by their age and risk factors, such as mammograms, pap smears, and so on, but that other screenings performed at the annual exam (EKG, certain blood work) were pointless, and could even lead to more unnecessary additional tests and treatments due to false positive results.

The article gives one pause. Long a tradition in the U.S., annual physicals seem untouchable. Barring any sickness, visiting the doctor for preventive care once a year ensured you had your blood pressure checked, your breasts or prostate examined, and your cholesterol evaluated. So, aren’t annual exams necessary? Well…

  1. Is the annual exam the only time you see your doctor? According to many studies, the majority of patients who come in for an annual physical have already seen their doctor for another reason during the previous 12 months. Preventive care is indeed valuable, but chances are if you’ve seen your doctor several times during the year, preventive issues were discussed already. In one study, Ateev Mehrotra, an assistant professor at the University of Pittsburgh School of Medicine, found that almost all the important health counseling and testing  – PSA testing to mammograms – happens outside of general physicals. It’s absolutely important to have screenings done as indicated by your age, gender, and general health, but it doesn’t always take an annual exam to ensure these are given.
  2. How old are you? The truth is, the older we are, the more risk factors we develop. And conversely, the younger you are, more preventive care may be needed for vaccinations and developmental milestone checks. If you don’t visit the doctor often, he or she will check your weight for obesity or unintended weight loss signifying a health issue, blood pressure, urine for diabetes and kidney disease, blood for elevated cholesterol and thyroid disease, bone health, and pelvis for infection or cancer indicators. These are all necessary screenings and become more so as we age. If you’re a parent, we assume you already take your child/ren to the pediatrician for wellness checks. Again, if you’re seeing the doctor only once a year to keep on top of your health, then the annual exam is the only time you will have these screenings.
  3. What medications are you on? If you are on say, a cholesterol drug, antidepressant, or birth control pill, you should visit your doctor periodically to evaluate the efficacy and safety of those prescribed drugs, especially if you are on multiple medications.
  4. How’s your health behavior? If you smoke, lead a sedentary life, and so on, it’s a good idea to see your doctor regularly for disease prevention assessment and health counseling. We all need reminders to get back on track sometimes!

Whatever you decide is right for you, that doctor-patient relationship is vital. And whether you maintain it with a yearly exam or a series of check-in visits, it’s not the timing of the exam, but that you continue to stay on top of your health, that matters.

Debbie Anderson is a 44-year-old freelance writer and editor who blogs at her slice-of-life site,

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