Annual physical may be a feel-good, unneeded visit

Published: Friday, Oct. 26 2012 5:11 p.m. MDT

Mercedes Sanchez reads a chart during her annual eye exam at the William F. Ryan Community Health Center in New York, Wednesday, June 27, 2012.

Seth Wenig, ASSOCIATED PRESS

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Research is questioning the old advice to see a physician once a year as a way to head off health problems. Danish researchers say there's no evidence the annual physical reduces cancer or heart disease deaths — or other deaths overall.

“We did not find any signs of benefit,” on death risk, researcher Lasse T. Krogsboll, a graduate student at the Nordic Cochrane Center in Copenhagen, Denmark, told WebMD.

The researchers gathered data from 14 studies involving more than 180,000 people. Each study assigned people to one of two groups: The first got regular checkups, while the second saw the doctor as needed. The people were followed for between 4 and 22 years, depending on the study design. They deliberately didn't include studies that involved only those 65 and older.

According to WebMD's Brenda Goodman, some of the studies indicated patients were more likely to be prescribed drugs for high blood pressure and other health issues if they had a regular physical, but not all the studies found that. And some patients received such treatments when they went in as needed for other conditions, as well.

"There was a trend among studies for people who got regular physicals to feel healthier than people who did not, but researchers say that finding is unreliable. There were no apparent differences between groups on hospital admissions, worry, referrals to specialists, or disability," Goodman wrote.

"We're not saying that doctors should stop carrying out tests or offering treatment when they suspect that there may be a problem," Krogsboll told Catholic Online. "But we do think that public healthcare initiatives that are systematically offering general health checks should be resisted."

According to Medical News Today, one disadvantage to an annual wellness check is the potential for diagnosis and treatment of conditions "that may never produce symptoms of disease or shorten life."

Results were consistent across their studies, the researchers said. They did note that other outcomes "were generally poorly studied, but suggest offering general health checks has no impact on hospital admissions, disability, worry, specialist referral, additional visits to doctors or time off work," Medical News Today's Catharine Paddock reported.

Eliminating annual physicals would save money partly because it would reduce unnecessary testing, Dr. Doug Campos-Outcalt, chairman of Family, Community and Preventive Medicine at the University of Arizona College of Medicine, who was not involved in the study, told Fox News. And while it might be easier for people to remember to go to a doctor once a year, electronic health record and patient reminders could remind them to go at longer intervals, he noted.

It's not a new view, either. The study, published in The Journal of the Cochrane Library, echoes other research and previous discussions on whether the benefit is worth the cost, both financially and in terms of a person's time in an increasingly busy, even harried world.

"The debate about physicals has been going on for more than 100 years. In the 1960s and 70s, two large randomized controlled trials were conducted, and both studies showed little positive impact — people who had physicals did not seem to live longer or have less illness than those who did not have physicals. ... Most patients in this country believe an annual physical is necessary, but there's little evidence to support that at this time," Dr. Ateev Mehrotra, assistant professor at the University of Pittsburgh School of Medicine, told Time magazine back in 2008.

He noted then that 20 percent of Americans get an annual general physical, at a cost of $7.8 billion a year. When he looked at eight key preventive health procedures, he said almost all the "important counseling and testing" happened not during the annual physical, but when someone came in for other reasons.

EMAIL: lois@desnews.com, Twitter: Loisco

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