About 78% of U.S. adults, including 68% of adults under 45, reported seeing a doctor in the last year for a wellness check.
Is this a good use of your and your doctor’s time?
Academic studies of the value of the annual physical exam (APE) have focused on whether doing this saves lives. Here the evidence is mixed. An analysis of many large observational studies reported an impressive 45% reduction in mortality comparing those who had vs. those who did not have an APE.
As regular readers know, this type of study is often misleading. People who have an APE are likely to be more health-conscious and have better health habits than those who do not. Smaller randomized trials of APE/no APE found very little mortality benefit.
Why might an APE help you live longer? It is an opportunity for your doctor to review your overall health rather than focusing on a specific problem. It is the ideal time to discuss and perform (immunizations, pap smears) or schedule (colonoscopy, cholesterol blood tests) important preventive health measures.
In a young healthy person, the traditional head-to-toe physical is unlikely to find new conditions, but focused exams may. It is a great time for a skin check looking for cancer and to measure BMI and discuss weight if it is a problem. High blood pressure is generally a symptomless condition until far advanced and blood pressure should be checked annually.
An APE is also a good time to discuss sleep, diet and exercise and mental health. Smoking and alcohol use should also be discussed. Older adults may want to bring up hearing issues.
So, if you are a young adult who feels fine, and you are aware of the importance of good habits, you can probably skip the “routine physical.” If you do, be sure to get your blood pressure checked when you go in for a problem-focused visit and that you have had your cholesterol checked within memory.
If you are at risk for such chronic conditions as hypertension, diabetes or heart disease because of your weight or family history, schedule that visit.
If you are 50+ it is worth doing even if you feel fine; the biggest risk factor for many conditions is simply aging.
An APE is also a good time to be sure you and your doctor get along and review how their office works, including off-hour availability.
For many, a normal physical can also be reassuring.
Edward Hoffer MD is Associate Professor of Medicine, part-time, at Harvard.
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