Merits of Having an Annual Physical Examination

Fishing – one way to relax and stay healthy. (Dr. Noorali Bharwani)
Fishing – one way to relax and stay healthy. (Dr. Noorali Bharwani)

Most health conscious adults get a yearly physical examination. Sometimes people wonder whether it is worth going through the process on a yearly basis – especially if you have no health issues.

An article in the Canadian Medical Association Journal (CMAJ November 4, 2014) discusses the pros and cons of such a yearly ritual (The periodic health examination in adults by David Ponka). The main purpose of this yearly ritual is for screening and preventive purposes.

This ritual dates back to at least the industrial revolution, when employers paid for annual check-ups to keep their labour forces healthy, says the CMAJ article. Now the practice has become one of the duties of a family doctor to keep the patients healthy. Interestingly enough, it is not an insured service in all provinces.

The question usually asked by the people who consider this an unnecessary expensive yearly ritual is, “Does it keep the adults healthy?”

The answer to this question is unclear, says the article. Some countries, such as the United Kingdom and Germany, encourage yearly physical examination for otherwise healthy adults aged 40–75 years. The reason being that this group has an increasing burden of lifestyle and chronic diseases that may be amenable to intervention. In Canada, the trend is toward reducing or eliminating the use of such yearly rituals in adults. One way is to disallow coverage by the health insurance plan.

There are some advantages to yearly physical examination for high-risk patients compared to low risk patients. The annual visit to a doctor provides opportunity to perform evidence-based preventive tests, to counsel patients on lifestyle issues, update vaccinations and, importantly, to identify risk factors and diagnoses through updating the patient history, says the article.

There is no scientific evidence to show that the annual physical examination reduces sickness and death in the community. On the contrary the annual ritual may lead to too many blood tests, chest x-rays and ECGs, exposing patients to the risks of investigation, such as false-positive results and over diagnosis.

Choosing Wisely Canada is a campaign to help physicians and patients engage in conversations about unnecessary tests, treatments and procedures. They have a very interesting website. You can Google it. It’s recommendations on periodic health examinations are:

-Don’t do annual screening blood tests unless directly indicated by the risk profile of the patient.

-Don’t order screening chest x-rays and ECGs for individuals with no symptoms.

The article says that the value of a regular (not necessarily annual) physical examination may lie in other factors like:

-To assist marginalized groups who would otherwise not attend regularly

-It may also assist in efforts around management of chronic disease and over medication.

What do you think? If you are not sure whether you need an annual physical examination then discuss with your family doctor. Greetings for the holiday season. Be safe and eat less.

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