Annual physical exams…are they really necessary?

I hate going to the doctor’s office.  The truth is that I just don’t like getting shots (odd, because I don’t mind giving blood) and almost every year through grammar school and high school the annual visit included a shot for a vaccine or the flu shot. Before coming to Happy Valley, I had to go to the office so I could receive the Meningococcal vaccine, the one required if you live on campus. Just the name of that vaccine makes me shiver. Needless to say, I wasn’t thrilled when I had to go back for a flu shot, during the Thanksgiving break. When we were leaving the nurse at the counter asked about making an annual checkup appointment. Really, still? I started thinking about why we get an annual physical. Sure, if you are a child who needs vaccines or play on an organized sports team and need clearance to play, you should go to the doctor annually. Annual visits to the doctor may be warranted for people over fifty as well.  But if you are a heathy adult, it seems unnecessary.

Null Hypothesis: Annual physicals are a necessary preventative measure for healthy adults.

Alternative Hypothesis: There is no need for an annual physical if you are a healthy adult.

Annual physical exams were endorsed by the American Medical Association in 1922 and have become part of a routine, for many, as a preventative measure and, for some, a reassurance that they are healthy. Routine physical exams normally include; a Q&A about general health, allergies, surgery and habits such as alcohol intake, tobacco use and frequency of exercise. They may also include urine tests and blood work and usually provide for temperature, blood pressure, pulse and examinations of your throat and ears.

doctor-1

In an article by U.S. News Health Care, the question of the need for a yearly exam is examined and concludes that annual visits to the doctor are not necessary. It suggests that if you are a healthy adult, visiting a doctor every 5 years would be reasonable. To support this conclusion, a study, by the Cochrane Collaboration, was referenced. This study analyzed results from 14 trials which included approximately 183,000 participants. The analysis showed that there was no effect on risk of death associated with cancer, cardiovascular disease or illness. One trial did detect an increase in cholesterol and high blood pressure, however, the analysis concluded that these patients may have already been suspected of high risk in these areas. Lastly, the trials were determined to have not influenced increased visits to doctors, work absences, disability claims or hospital admissions although, the data was vague and could be subject to the File Drawer Problem, Andrew discussed in class.

doctor-2

 

This Harvard Health Publication blog supports the elimination of routine annual visits stating that the visits do not stop you from getting sick nor prevent death. It states that, statistically speaking, tests ordered on healthy people produce false positive results identifying problems that don’t exist. It concludes that the emotional, financial and resource costs to conduct these tests are enormous and should be redirected to those truly in need. It suggests that online surveys and rigorous preventative steps by individuals can replace annual visits. This report references an article posted in the The New England Journal of Medicine which also provides convincing arguments to change the annual routine and consider visits based on evidence rather than the calendar. It agrees that false positive testing can do more harm than good and wastes a lot of everybody’s time.

Alternatives to annual physicals

WebMD documents when to get screened for the detection of particular ailments. It suggests, for instance, a cholesterol test every 4-6 years and a colonoscopy starting at 50 years old. Mammograms for women at 40 years old are recommended and blood sugar tests for those overweight should be considered. Of course, if you are predisposed to certain ailments or have a family history of disease, screening is warranted.

Conclusion:

The research presented disproves the null hypothesis and accepts the alternate hypothesis that annual physicals are not necessary for healthy adults. During high school, I sponsored several blood drives. Since arriving at college, I have donated blood. When you donate blood, you are screened for a variety of things such as; weight, iron level, blood pressure, temperature, and pulse and you are asked to complete a lengthy questionnaire about your current health, travel, surgeries and habits.  Sounds a lot like a routine physical to me and it is free! So, if you don’t have time to get to the doctor’s office, you can’t afford it or you just want to be a good person, donate blood and get a mini check-up for free!

Picture sources:  http://www.usnews.com/dims4/USNEWS/ea8044b/2147483647/thumbnail/970×647/quality/85/?url=%2Fcmsmedia%2F74%2Ff0%2F5157150e4b7d8e55bbb0cb911c4f%2F140529-doctorexam-stock.jpg

http://knue.com/despite-the-study-about-annual-checkups-will-you-continue-to-go-pollvideo/

References

Physical Exam:

http://www.healthline.com/health/physical-examination#Overview1

U.S. News Health Care:

http://health.usnews.com/health-news/patient-advice/articles/2015/09/30/the-annual-physical-do-you-need-a-yearly-exam

Study: Cochrane Collaboration:

http://www.cochrane.org/CD009009/EPOC_general-health-checks-for-reducing-illness-and-mortality

Harvard Health Publications, Harvard Medical School:

http://www.health.harvard.edu/blog/a-checkup-for-the-checkup-do-you-really-need-a-yearly-physical-201510238473

The New England Journal of Medicine: Improving Value in Health Care – Against the Annual Physical:

http://www.nejm.org/doi/full/10.1056/NEJMp1507485?af=R&rss=currentIssue

Webmd Screening timelines:

http://www.webmd.com/a-to-z-guides/annual-physical-examinations#3-9

Screened (blood donation):

https://www.bcw.edu/bcw/Blood-Donation/becoming-a-donor/index.htm?tb=4&gclid=Cj0KEQiA6_TBBRDInaPjhcelt5oBEiQApPeTF3KxxQAIFBCwU3FP3_N1uvxbC3BVAxLS9BZ2UKaB6RUaAta68P8HAQ

6 thoughts on “Annual physical exams…are they really necessary?

  1. Luyi Yao

    This post is very good and logical. I do agree that we do not necessarily have an annual physical exam if we are healthy now. But I think we also need to have a regular calendar for physical exam because if we cannot figure out problem in time, we may lose chance to resolve it. You have done your post well, and I really admire that you donated blood. I’ve donated blood in my hometown, and I clearly remember the feeling that I found my blood was flowing. It was not a good feeling but it was very valuable.

  2. Lucille Laubenstein

    While I do think this blog was well researched, and well structured, I do wish you had provided a counter argument, to help demonstrate the costs and benefits of the exams, and providing a different perspective. However, one thing that did strike me as odd about your blog, and these studies, is that they kept using the term “adult” as a category of people, and making recommendations for this “adult” category. This is troublesome because from a legal outlook the term adult starts from the age of 18. But the age in which people are considered elderly is a little more fuzzy with ever growing longevity. So for argument’s sake, let’s say that someone is considered elderly at age 75. Therefore people of this age no longer fit into this category and thus their advised medical care and needs would be different. However that still leaves a massive range of ages which fit into that “adult” category. I, as an 18 year old person have different things factoring my health than my 55 year old father. He too, has different factors influencing his health, and things to be wary about than my 52 year old mother. If I had any grandparents left (They all died in their sixties, during this determined age range), they would have different health needs than my parents. That is not even taking into consideration gender differences, socioeconomic differences, lifestyle differences, ethnicity, location difference, the list goes on and on. There are simply too many confounding variables to make that kind of a blanket statement. I think the next step would be to conduct studies which look at a a specific group of people, much narrower than the group “adults”, and make recommendations based on that. But there seems to be no way to get an effective take on the subject. I would say that the best thing to do would be to have an honest conversation with your doctor about your health and needs, and make a plan based on that which is tailored specifically to do. Everyone is different so it is impossible to say what the needs of an individual should be.

  3. Nicholas E Schneider

    I really enjoyed reading your article because it presents a topic that is interesting and relevant to nearly everyone and it also sparked a variety of thoughts and opinions for me. Personally, I agree with your conclusion that annual physical examinations are unnecessarily frequent and agree these appointments can be a nuisance. However, while such frequent check-ups are probably unnecessary (as in, not completely essential to good health), I do feel as if they are 100% worth it. The reason so many people feel that an annual physical is not needed is because they rarely receive an unexpected diagnosis at a check-up. With this being said, on the off chance a doctor does discover some sort of ailment in a patient while conducting a physical, I’m positive that this patient would be grateful his/her condition was noticed in a timely manner rather than once it was too late. Just under two years ago my uncle went to the doctor for his annual visit and it was there that doctors discovered he had cancer. The cancer was caught very early because it had only been a short time since my uncle’s most recent examination and as a result he was able to make a full recovery. Had my uncle waited another 3-5 years to return to the doctor, the timetable proposed in your post, it’s much more likely that my Uncle’s cancer could have worsened or spread throughout his body and he may not have been so lucky. These annual physicals may seem more like a nuisance than anything else, but they save lives on a daily basis.

  4. Olivia Anne Browne

    I think this was a great post. Being that I hate the doctor, I love this post. I do think seeing the doctor at our age is super important. I do agree with a lot of your points, however as much as I hate going, I do think it is important due to the fact that you can have certain issues caught early and then resolved. I think your research and information is generally good and overall I think its a good post. I also loved your conclusion about donating blood and how it can be basically a free physical.
    Check out this article on how often you should see a doctor and how educated the doctors are to this.
    https://www.washingtonpost.com/posteverything/wp/2015/06/12/doctors-dont-actually-know-how-often-you-should-see-them/?utm_term=.b087b1c0acce
    Enjoy!

  5. Kateryna Okhrimchuk

    Michael,
    Although I agree that annual physical exams are both annoying and can be costly (especially if you don’t have insurance), I still believe that they should be required every single year. Considering the fact that we live in a country where the two leading killers are heart disease and cancer, having the opportunity to catch either of those things early gives you a much higher survival rate than if you get diagnosed when you actually start showing symptoms. WebMd, the website that gave alternatives to annual physicals, is also not very credible. Even if it was, though, the timeline for screenings that these provide is just a suggestion and makes people out to be “one size fits all”. If you are 100 pounds overweight and trying to change your lifestyle, you will definitely need a cholesterol test more often than the suggested WebMd time, 4-6 years. And anyway, why would you want to risk having something seriously wrong with you, something diagnosable and detectable on a physical exam, and missing it just because you didn’t want to spend an hour at the doctors office?

  6. Lauren Eve Ribeiro

    I found this article super interesting. Although I agree with some of your points, I think that physical exams should still be practiced. Sometimes people do not feel anything, but have health problems. For example, last year during my physical my doctor ordered me to get a blood test because during the questionnaire of my physical I had answered that I had been feeling tired (I just thought it was college and all the schoolwork getting to me). When the results came back it turned out that I had some health problems. If I had not gone to my yearly physical these problems could have gone unnoticed which could have been very dangerous in the long run. Doctors know what is best for you and are trying to help you to stay as healthy as possible.

Leave a Reply