You’re healthy — at least as far as you know. But if you’re like countless other Americans, you see your doctor once a year just to make sure.
This annual checkup may be wholly unnecessary for healthy adults, according to a growing number of experts. (To be clear, we aren’t talking about exams for children, the elderly or people with medical conditions.) Still, a Kaiser Family Foundation poll found 92 percent of Americans believe it to be an important part of their health care.
Taking a look at the evidence on just how useful these appointments are — and for whom they’re appropriate — could save you from potentially unnecessary doctor visits and the associated costs.
“I’ve been going for annual checkups since I became an adult, so for 27 years,” says Rebecca Dillow, a 44-year-old community grant coordinator in Newport News, Virginia. Dillow, like many other healthy Americans, sees the annual evaluation as a sort of safeguard against health problems of which she may not yet be aware.
How Annual Checkups Came to Be
The idea of healthy people seeing their doctors at periodic intervals to make sure everything is OK didn’t become widely popular until about the start of the 20th century, when the life insurance industry began requiring physical exams during the life of a policy instead of just at sign-up time. Despite there being little evidence then that such exams decreased mortality, according to the Annals of Internal Medicine, private doctors soon embraced the idea of periodic physical examinations. In 1922, the American Medical Association formally endorsed the practice.
Over time, the annual or periodic checkup was accepted as part of standard medical practice, both by doctors and patients, and it remains that way for the majority of patients today. Some doctors, however, are re-evaluating the need.
Growing Doubt Over Usefulness of Annual Physicals
Over the last several decades, numerous studies have failed to find a connection between periodic health evaluations in healthy people and reduced mortality or improved health outcomes. Groups including the American Medical Association, United States Preventive Services Task Force and the Society of General Internal Medicine have moved away from promoting the yearly head-to-toe exam in symptomless, healthy adults.
A 2012 review from the Cochrane Collaboration, a nonprofit organization that surveys medical research around the world, looked at 14 clinical trials involving more than 180,000 people and the effect of “general health checks for reducing illness and mortality.” Their findings: The checkups had no effect on hospital admission rates, absences from work, disability, specialist referrals, additional doctor visits or even patient anxiety. They didn’t improve patient health or reduce mortality, and the review concluded the checks were “unlikely to be beneficial.”
In a recent editorial in The New York Times, bioethicist and fellow of the Center for American Progress Ezekiel J. Emanuel wrote that “the annual physical examination is basically worthless” and argued for readers to skip it altogether. But, he said, he would go through with his own flu shot once a year and colonoscopy every 10 years — things “proven to reduce morbidity and mortality.”
But some regular screenings are justified, and for some populations, the annual once-over is not only worthwhile, but necessary.
Who Should Get an Annual Checkup
The need for physical exams by your doctor is highly individual. There’s no standard recommendation for how often healthy people should see their doctors. The best advice: Ask your doctor how often she wants to see you.
Age and being at high risk of certain diseases can justify annual checkups, even in otherwise healthy people. Older adults are more likely to fall ill, so your doctor may wish to see you every year beginning at age 65, or younger if there are other risk factors. Likewise, having risk factors — such as borderline high blood pressure or prediabetes — could warrant regular check-ins no matter your age.
It should go without saying that if you have a chronic illness, even when you have it under control and are feeling good, more frequent check-ins are called for. These visits aren’t simply looking for an illness or condition you don’t know about, but are a check on your current state of health in light of a condition (or risk factors) you already have. If you’re on a prescription drug regimen, that’s a good sign that annual or even more frequent checkups are warranted.
For Dillow, and likely other healthy adults, the annual visit is an exercise in self-awareness and preventive monitoring.
“Although I don’t have any health conditions, I go for several reasons,” she says. Her mother always recommended it, and seeing how many medications her mom had to take for various conditions later in life was an additional motivator. “Also, I come from a family of diabetes, high blood pressure, obesity, high cholesterol, heart disease and cancer, so I made the conscious decision at a young age to stay on top of it and go to these checkups as a preventive approach.”
Know When to See Your Doctor
If you’re a healthy adult with no symptoms of illness and no chronic conditions, you can probably put off seeing your doctor until the next time you’re sick. Some experts suggest every five years is a good check-in rate for healthy people who haven’t been in the office otherwise.
Preventive health screening recommendations can also be a good guide for how often to check in with your doctor, as they’re fairly rare for most risk-free adults but increase with age. Mammograms, for example are generally recommended every two years after age 50, and colorectal cancer screenings annually after age 50 and with certain risk factors present.
Many of the things a healthy person might go to a doctor for don’t require a physician appointment at all — immunizations and blood pressure checks, for example. You can likely get these at a local pharmacy or at a clinic without seeing your doctor.
When the Annual Exam Pays Off
For some, the annual physical is less about the exam itself and more about having one-on-one time with a medical professional. And, despite the research that finds no benefits to checkups, some annual exams prove to be an exception to the rule.
Dillow says her visits offer reassurance that she’s doing as well as she hopes. In 2006, the visits paid off in another way. At her annual checkup, her doctor flagged a slightly elevated cholesterol level, leading Dillow to change her diet — and her perspective on her health overall. She got her numbers under control strictly through healthier eating, she says. “I realized that the foods I put in my body have a direct impact on my health. At 44, I feel better than I did at 24!”
The final word on annual exams hasn’t been written. But if you’re a healthy, symptom-free adult, research suggests you can let go of the annual tradition. Visit your doctor when you have specific health concerns, or you simply want to affirm that you’re on the right track.
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The Annual Physical: Do You Need a Yearly Exam? originally appeared on usnews.com
