The Yearly Checkup

March 13, 2008 8:45:43 PM PDT
Are annual medical exams really the key to good health?The answer from some doctors might surprise you.

If you want to stay healthy - eat right, exercise and see your doctor once a year, right? It's what we've been taught for years. Despite conventional wisdom, some experts now say that checkup may be overkill.

"It gives me piece of mind, that's why I'm so happy about going to have my physical," said Valeria Hampton.

"I do get yearly physicals, and I think the most important part of that is the comprehensive blood tests," said Mary Foster.

But does a healthy patient really need to see his doctor yearly to stay well?

"I think many people are surprised to learn there's a great deal of controversy about whether physicals lead to that goal," said Dr. Ateev Mehrotra, University of Pittsburgh Medical Center.

Mehrotra and colleagues from Harvard studied yearly preventive checkups.

They found annual exams are the number one reason adults see their doctor. Sixty-three million Americans have them at a cost of more than $7 billion a year. But according to the study, more than one-third of annual physicals include unnecessary testing.

"We're spending a lot of time and a lot of money on these visits," Mehrotra said.

Mehrotra says no major clinical group recommends annual exams, and his study left researchers wondering whether regular visits were clogging up the system.

"Surveys have found many patients are having great difficulty getting in to see their physician on a timely basis for an urgent reason," Mehrotra said.

Family health physicians at Rush University Medical Center favor preventative visits. But say those check ups may not have to be yearly unless the patient is high risk.

"Does it have to be an annual top-to-toe, rotate the tires, change the oil, look under the hood? Not necessarily, but there are some very specific things that have very clear benefits," said Dr. Steven Rothschild, Rush.

If you have a family history of disease such as cancer, a yearly exam seems to make sense. And researchers found some preventive services are critical, like mammograms, pap smears and colon cancer screening.

"It makes more sense to identify them early on as opposed to wait till they are sick then they become more costly to the system," said Dr. Joel Augustin.

But, researchers also find 80 percent of preventative care takes place when patients are in for another reason.

"When someone comes in for a cough or cold or rash or one of those problems, we try to squeeze in the evidence preventative stuff right then and there so no one is making a special trip," said

This debate won't end any time soon. Another study in the "Annals of Internal Medicine" says routine physicals are justified because they increase the chance patients will get critical screening tests. The exams can also ease a patient's worry about their health.

"You need to have that physical so you can stay alive as long as possible," said Ernest Scott.

The jury's still out on exactly how often you should see your doctor for a physical exam and what should happen at such a visit. Researchers hope their findings will lead to future recommendations for yearly checkups and what tests should be performed during those exams.