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Annual Medical Physical May Be Unnecessary for Healthy Adults

While many doctors encourage routine medical check-ups for healthy adults each year, others have raised doubts whether this is really necessary. There is also the issue of overdiagnosis and overtreatment, which  may actually cause harm.

Doubts about any benefits from annual general medical physicals, medical tests, and screenings for healthy adults (who have no symptoms) have been expressed for years by physicians, researchers, and some studies not finding any benefit (e.g., no decreases in heart disease, stroke, and deaths). Other countries also do not recommend all these routine screenings for healthy adults with no symptoms.

I recently came across the following interesting article by Dr. Jeremy Faust, a physician who writes at Inside Medicine. His background: MD, MS, board-certified emergency physician, founding editor of Brief19 (daily reports by physicians on the frontline of COVID-19), researcher, and author. He recommends a primary care doctor, but not an annual check-up for healthy adults (no symptoms), and discusses research supporting this.

Excerpts from Dr. Jeremy Faust at Inside Medicine: Do you really need a routine medical checkup?

Have decades of medical progress since changed the prognosis for routine checkups? To find out, a group of researchers in the United States recently analyzed the results of all the trials performed by other researchers since. The findings were recently published in the Journal of the American Medical Association. ... 

The studies, from the US, the UK, Denmark, and Sweden, including ones whose findings have been published in just the last couple of years continue to find the same thing. For all of our innovation and technology, routine checkups don’t appear to extend life—or stave off early death or early cardiovascular events like heart attacks and strokes. In fact, in one study, routine checkups were surprisingly associated with higher mortality rates in older adults. The researchers later determined a perfectly good reason for this. Those attending regular checkups were more likely to have filled out advanced directives stating that they did not want their lives to be artificially extended by having to live on machines.

The evidence suggests that I don’t need an annual physical. That’s good because I haven’t had one in years. What I do need, what we all need, is a primary care doctor to check in with from time to time. I need someone to keep track of what vaccines I’ve had, and which ones I need, which screening tests I’ve had, and which I need. I need someone to go to when a nagging problem, but not an emergency, comes up. At the core, the studies mentioned here do not refute the idea that modern medicine can treat many symptomatic diseases, many of which do require checking in with your doctor from time-to-time. What they do show is that other than vaccinations, most of which we receive in childhood, very little else in preventive care has an explicit mortality benefit.

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