The neighbor on my right is a fit looking 42 year old man. He goes to the doctor every year. He gets the full work up - updated medical history, head to toe physical exam, basic lab work.
The neighbor on my left is a fit looking 41 year old man. He hasn’t been to the doctor in four years, because he feels fine.
Who is better off? That’s a good question. It turns out there is some disagreement on the value of yearly preventive health exams for asymptomatic adults.
Let me stop here to emphasize asymptomatic. If you have palpitations, a weird looking mole, joint problems, or something else going on that isn’t quite right, you are not asymptomatic. Go to the doctor.
For everyone else, though, it may not be worth it to head to the doctor every year when you are feeling fine and dandy.Research conducted on behalf of Veterans Affairs looks at the value of annual physical exams in adults with no complaints. It reviewed available research on the topic and the final determination was as follows:
“Comprehensive routine physical examinations are not recommended for the asymptomatic adult,although many patients and physicians continue to endorse the practice.”
Well, if that’s not good news for the Healthy Couch Potato, I don’t know what is.
But wait. The study did recommend certain components of physical exam. These include a blood pressure screening every one to two years, periodic measurement of body mass index, and pap smears for sexually active women with a cervix every three years between the ages of 21 and 65.
The study further acknowledges there is some evidence that patients will have pap smears, cholesterol screening and fecal occult blood testing if they have specific visits for the purpose of well care. (Screening tests which usually happen outside of the office visit, such as mammogram and colonoscopy, aren’t addressed in this study.)
In addition, some physicians continue this practice because they believe that it promotes a strong physician-patient relationship which is invaluable should real health problems arise.
So how could it be a problem for a doctor to see his symptom-free patients every year? Think of these visits a little like buying and selling individual stocks.
First, there is a transaction fee, even though you probably don’t pay it personally. Most insurance plans under the Affordable Care Act cover them. Even so, it’s still a cost that adds billions to the country’s total healthcare bill.
Second, the benefits of these visits are offset by risk. Every interaction raises the possibility of a false-positive. Maybe the doctor will find a lump in your abdomen or a nodule on your thyroid that turns out to be nothing - after an extensive work up.
This information, like anything else related to your health, leaves you with some decisions to make. So how to proceed?
Question your doctor. If you’ve been visiting him every year, ask why. Just because a study recommends for or against a practice for a population, doesn’t mean that’s the right answer for you. You or your doctor may have compelling reasons to continue your annual visits. That’s okay, but just like any medical intervention, it should be done with purpose after considering benefits and risks.
Question yourself. Will you tend to preventive measures without those visits to keep you on track? If not, maybe those annual doctor visits are important for you after all. The study mentions that the rise of electronic medical records will make this less of an issue, as electronic reminder capabilities will keep you on track. Regardless, if you decide to skip the annual exam, have a plan to keep on top of those screening tests.
So, who is better off, the neighbor on my right or the neighbor on my left? It’s the one whose approach is part of an overall healthcare plan that he has developed in consultation with his doctor. And his plan may be completely different than yours.
Amy Rogers MD is not a practicing physician and nothing written here should be taken as medical advice from either Amy or AssetBuilder. Medical decisions should be made with care in consultation with your health care provider.