The Annual Physical – Is It Still Relevant?
The annual physical exam – it is as much a part of a standard wellness regimen as healthy eating, exercising regularly and not smoking. After all, doesn’t every well-intentioned piece of medical advice end with the admonition to either see the doctor once a year or discuss with the doctor your risk for (fill in the blank)?
So it may come as a surprise that there are renewed calls in the medical community to do away with the routine, once-a-year medical appointment for those who aren’t sick. Since about a third of American adults get one every year, there’s no question that plenty of money (an estimated $10 billion per year) and time (that of providers and patients) is spent on these visits. At some point, it’s worth asking whether the money is being spent wisely when healthcare costs are undergoing intense scrutiny, and whether providers’ time could be better spent when more urgent health matters cannot get attention. Those two factors alone – time and money – raise questions about the net benefit of the annual physical as a standard directive. From a purely data-driven, bottom-line point of view, the annual physical is not proven to save lives or improve overall health, although it clearly has other benefits.
Part of the problem is the wide variety of ways the annual physical is conducted. It’s difficult to study because it’s hardly a uniform experience from practice to practice. Unfortunately, it is frequently a hurried, questionnaire-driven, rapid-fire exchange about symptoms, medications and lifestyle, often with a mini-exam. Then some age-related or appropriate tests and screenings might be ordered and occasionally some new findings are shared on a relevant medical topic. No question all of that has some value, but maybe the bigger issue is whether that precious time could be better spent between provider and patient – and if so, how?
Routine appointments provide the necessary background for screenings, preventive measures and educational efforts needed to maintain wellness. Without getting deep into the structure of reimbursements, the annual physical is in a special category because it starts that conversation so it is considered more valuable than a standard office visit. But it has the potential to provide benefits that may be beyond our ability to measure.
The trusted doctor-patient relationship is paramount to good medicine and the research bears this out. Well-established patients are more likely to seek medical care when needed, stick to treatment and procedures advised by their providers, and generally better comply with preventive health measures. Then there’s the documented therapeutic (as well as diagnostic) value of a gentle, thorough, considerate physical exam. It’s no accident that many professionals now promote a once-a-year “check-up” in a variety of fields, for the opportunity to share new knowledge, diagnose problems and maybe most important – reaffirm an important relationship.
As with many interactions in life, the annual physical has changed significantly over the years. More ground needs to be covered, technology makes it feel less personal and we’re all strapped for time so it tends to be rushed. But when it comes to a person’s physical health, ensuring that a scheduled amount of time each year can be set aside to evaluate and discuss the overall picture regardless of symptoms, the annual physical has never been more relevant.
At Lisa Larkin, MD, and Associates, we believe in an innovative model of care (which does include an annual physical!) Click to learn more about our practice.