Annual physical examination unnecessary

Experts say there is little medical evidence of benefits from annual physicals for healthy patients experiencing no symptoms, according to the New York Times. This suggests that they are an unnecessary medical expense that adds to the cost of health care and exposes patients to unnecessary risks.

Checkups for people with no medical complaint still remain the single most common reason for visiting a doctor:

  • In 2000, they accounted for about 64 million office visits out of 823.5 million visits overall.

  • At $120 to $150 per visit, that adds up to more than $7 billion a year.

    An expert committee sponsored by the federal Agency for Healthcare Research and Quality found little benefit in many of the tests commonly included in a typical physical exam for symptomless people:

  • It found no evidence that routine pelvic, rectal and testicular exams made any difference in overall survival rates for those with no symptoms of illness; furthermore, such tests can lead to false alarms, necessitating a round of expensive and sometimes risky follow-up tests.

  • And even many tests that are useful, like cholesterol and blood pressure checks, need not be done every year.

  • Other time-honored procedures -- listening to hearts with a stethoscope, thumping chests and looking at eyes, ears and throat -- provide no medical benefit for healthy patients with no symptoms.

    Many doctors do a careful physical exam on a patient's first visit to serve as a baseline. But on subsequent visits, say groups like the Agency for Healthcare Research and Quality, patients would be better off if doctors spent their time counseling them on such things as stopping smoking, eating a healthy diet and drinking moderately, using seat belts and having working smoke alarms in their houses.

    Source: Gina Kolata, Annual Physical Checkup May Be an Empty Ritual, New York Times, August 12, 2003.

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    For more on Preventive Medicine Health Issues

    FMF Policy Bulletin\19 August 2003
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