Do You Really Need an Annual Physical Exam?

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By Karla Bowsher

About 1 in 3 Americans gets an annual physical exam.

But a growing number of doctors now believe the practice is at best wasteful, and at worst potentially harmful, Time reports. Studies show little connection between the practice and disease prevention.

Dr. Ateev Mehrotra, of Harvard Medical School and Beth Israel Deaconess Medical Center in Boston, argues in today's issue of the New England Journal of Medicine that physicals should be restructured. He also writes that insurance companies should stop covering physicals because that gives doctors an incentive to continue the practice:

Though on a per-visit basis, the annual physical is not costly, it is the single most common reason that U.S. patients seek care, and cumulatively these visits cost more than $10 billion per year -- similar to the annual costs of all lung-cancer care in the United States.

Not only do physicals waste money, they waste time. About 10 percent of all visits with primary-care physicians are for physicals, and Mehrotra says the time doctors spend on those visits "might be crowding out visits for more urgent health issues."

In addition to being wasteful, Dr. Christine Laine, senior vice president of the American College of Physicians, tells Time that annual physicals can be potentially harmful.

Routine screenings can lead to abnormal findings, but not all such results are indications of health problems. Sometimes abnormal findings are one-off readings or false positives. Laine says:

"There is more evidence of harm than benefit, especially for executive physicals in which people come in once a year and get a zillion tests whether or not they need them. What usually happens is that they find things that they didn't need to find, and that generates more tests, which generates costs and side effects and worry and all of those things. There's good evidence that those types of exams don't make any sense and are of low value."

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