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Are yearly physicals for healthy adults necessary?


Despite the advice of national expert panels since the late 1970's, patients still ask for and physicians still perform unnecessary annual physical examinations each year. Annual general health check-ups, preventive health examinations, and periodic health evaluations have proved to--be less than beneficial to patients without symptoms.

The Cochrane Collaboration headed a study that looked at the outcomes from 14 randomized controlled trials involving 182,880 participants. The investigators studied groups receiving yearly check-ups and compared them with groups that did not receive them. Although the group receiving yearly check-ups received more diagnoses of various ailments, the examinations did nothing to reduce mortality rates, cardiovascular disease, or cancer-related conditions. The researchers concluded that such examinations were probably not beneficial and had no effect on general health, patient worry, absence from work, disability, or additional hospital visits.

The Cochrane team defined a general health check-up as any contact between a health care professional and an individual that was not provoked by symptoms; the visit is dedicated solely to counseling and screening tests. The purpose is to prevent future illness through early detection or to provide reassurance to patients. However, in rare cases, an unnecessary visit to the doctor may cause unintended consequences; physicians often overlook the psychological harm to patients and the financial costs of constant health screening.

Although these results appear to be counterintuitive, they agree with what others have been saying for decades. In 1979, the Canadian Task Force on the Periodic Health Examination recommended against annual general health check-ups. This was seconded in 1989 by the United States Preventive Services Task Force.

An annual physical could be less beneficial than one would expect when primary care physicians may have already intervened when they notice risk factors for disease in their patients. Further, people at risk for disease might not see a physician annually.

(Sources: Journal of the American Medical Association, December 12, 2012; Cochrane Database of Systematic Reviews, October 17, 2012.)
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Publication:Nutrition Health Review
Date:Mar 22, 2012
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