June 27, 2005

Annual check-up worthwhile? Docs think so

NEW YORK (Reuters Health) - For the last 20 years,
professional guidelines have advised doctors that there's no
evidence to show that an annual physical examination is
necessary for someone who doesn't have any apparent health

The message does not seem to have gotten through. A survey
finds that most primary care providers believe in the value of
annual check-ups, and are performing them anyway.

A postal survey was sent to 1679 primary care providers in
Boston, Denver, and San Diego, and 783 (47 percent) responded.

Sixty-five percent of respondents thought that an annual
physical examination is necessary, Dr. Allan V. Prochazka, from
the VA Medical Center in Denver, and colleagues report in the
Archives of Internal Medicine for June 27. Moreover, 88 percent
said they performed such examinations.

As an indication of the low awareness of official
guidelines, 55 percent of the doctors disagreed with the
statement that "national organizations do not advocate an
annual physical exam."

On the other hand, 63 percent of primary care docs said
that the annual physical is of proven value, and 74 percent
thought such exams improve detection of subclinical illness.

Also, more than 90 percent of the respondents believed that
an annual exam provides an opportunity to counsel patients
about preventative health, and improves patient-doctor

Seventy-eight percent thought that most patients wanted
such exams.

So why the gap between guidelines and practice? Two
editorialists suggest that there's more to an annual check-up
than meets the eye.

"We think there may be something valuable to the annual
physical that patients and physicians are telling us
indirectly," they say.

That message could lead to healthcare improvements "in ways
we might not even imagine," write Dr. Patrick G. O'Malley, from
the Walter Reed Army Medical Center in Washington, DC, and Dr.
Philip Greenland, from the Uniformed Services University of the
Health Science in Bethesda, Maryland.

"First, let us study (the annual physical), before we
abandon it," they conclude.

SOURCE: Archives of Internal Medicine, June 27, 2005.