HealthLawProf Blog

Editor: Katharine Van Tassel
Concordia University School of Law

Tuesday, October 16, 2007

Annual Check-Ups Overrated

It turns out those annual visits to your doctor are actually not that helpful.  According to an article in the Chicago Tribune


     Your doctor probably knows it. Medical organizations certainly do. But most  patients have no idea.  The annual physical examination -- that encounter when a physician looks in your throat, listens to your heart, pokes your abdomen, checks your reflexes and tests your blood -- is no longer a generally recommended medical practice. That's because there is scant scientific evidence showing that yearly checkups help prevent disease, death or disability for adults with no symptoms. Many tests and procedures performed during the visits have questionable value, experts say.

Instead of an annual physical, healthy adults should undergo a much-streamlined exam that's focused on prevention every one to five years depending on a person's age, sex and medical profile, the American College of Physicians and other professional groups suggest.

Men and women see physicians more frequently for yearly medical checkups than for any other reason, at a cost of $7.8 billion a year in the U.S., close to the $8.1 billion spent on breast cancer care, according to a recent report in the Archives of Internal Medicine. The figure reflects the strong attachment to this entrenched medical tradition felt by patients and doctors.  "There's a feeling of well-being you get from having your doctor look you over and pronounce you in good health," said Andrew Griffo, 48, a financial adviser who lives in Park Ridge and schedules a physical every year.  Largely out of public sight, however, the medical orthodoxy that all adults should undergo a comprehensive annual medical review to detect potentially significant clinical abnormalities has been under scrutiny since the 1970s. 

Experts' concerns revolve around two components of the traditional checkup: the comprehensive physical exam and an extensive battery of tests checking a person's blood, urine, thyroid and heart. (A third component, an updated patient history, hasn't prompted the same scrutiny.)   . . . .

Some believe that for many patients an annual checkup may not be needed at all. In fact, the new Archives of Internal Medicine study found most patients receive the bulk of recommended preventive care -- such as counseling about weight or blood-pressure checks -- not during physicals but on other occasions, such as when they see doctors about a cold or a chronic condition like diabetes.  The report also estimates that, a third of the time, routine physicals become an occasion for unnecessary tests such as electrocardiograms, boosting medical bills by more than $350 million and contributing to soaring medical expenses.

There's good reason to ask "whether the time and resources being spent are worth it," said Dr. Ateev Mehrotra, the study's lead author and assistant professor at the University of Pittsburgh School of Medicine.

Thanks to Ezra Klein for the link.

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