LET'S GET LESS PHYSICAL
February 15, 2006
Study after study has found that the annual physical exam is almost worthless, a medical anachronism that should be buried alongside the iron lung and mercurochrome. Some experts suggest, only half-jokingly, that there is hardly any reason for a healthy, symptom-free man or woman to ever again disrobe in a doctor's office, says Sara Solovitch of the Los Angeles Times.
- None of this stops patients from wanting a full-blown physical. Studies have consistently identified strong patient demand for routine blood tests, such as for glucose and hemoglobin levels, and renal, liver or thyroid function.
- Doctors appear keen on the physical too. Last year's Archives of Internal Medicine survey found that 65 percent of primary care doctors believe in the validity of the physical exam, 78 percent say patients expect it, and almost all -- 94 percent -- believe it improves the physician-patient relationship.
The result? Many primary care doctors continue to perform tests that seem to impart little benefit. Indeed, this disconnect can harm, says Solovitch.
- For one thing, physicals take up money and time. As much as one-third of all U.S. health care dollars is estimated as wasteful, and as medical costs continue to spiral skyward, the annual exam is attracting attention as one place to save money.
- The physical exam takes time that could be better spent, especially if a doctor only has 20 minutes before the next patient, says Dr. Harold C. Sox, editor of Annals of Internal Medicine.
Additionally, if you run enough tests on virtually any healthy person, you're going to find something out of the norm, says Dr. David Sobel of Kaiser Permanente Northern California. Then you have to do a lot of re-tests and assure the person that nothing is wrong.
Source: Sara Solovitch, "Let's get less physical; The yearly checkup is reassuring -- but unnecessary. To make it matter, doctors and patients must talk." Los Angeles Times, February 13, 2006.
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