The Importance of An Annual Check Up

August 25, 2007

2713261149.jpgDo we need annual physical exam? Why and How soon?

Actually there is still an ongoing debate as to whether annual exam is necessary or helpful.  Several institutions have abandoned the requirement of subjecting healthy subjects to this annual routine.  But in a recent survey published in the Archives of Internal Medicine … majority of the doctors and patients alike i.e. 9 out 10 surveyed out of the 800 still believe that annual physical exam do more benefits than harm.

In a recent publication from the Annals of Internal Medicine, Feb 2007 issue, a study was done to determine if indeed it is beneficial to have one:

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Data Synthesis: The best available evidence assessing benefits or harms of the Physical Health Exam or PHE consisted of 21 studies published from 1973 to 2004. The PHE had a consistently beneficial association with patient receipt of gynecologic examinations and Papanicolaou smears, cholesterol screening, and fecal occult blood testing. The PHE also had a beneficial effect on patient “worry” in 1 randomized, controlled trial but had mixed effects on other clinical outcomes and costs.

Conclusions: Evidence suggests that the PHE improves delivery of some recommended preventive services and may lessen patient worry. Although additional research is needed to clarify the long-term benefits, harms, and costs of receiving the PHE, evidence of benefits in this study justifies implementation of the PHE in clinical practice.

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This study has showned that one or more well visits per year may actually be beneficial to patients and doctors alike by improving patient- doctor relationship as well as alleviate patient’ worries.

By having an annual exam, one is able to check the onset of certain conditions where the abnormality will not show symptoms but may manifest initially with a biochemical or laboratory abnormality.  Healthy subjects specifically with a family history of known inherited conditions like diabetes, hypertension or high cholesterol will definitely benefit by having one.  More so with patients whose parents have a history of tumors or cancers of whatever organ should have routine annual exam.

Routine tests that have been shown to be beneficial in screening includes a fasting blood sugar, liver function tests, lipid profile to check cholesterol, occult blood and urinalysis.  Certain procedures like pap smear and breast exam for women are also beneficial since early detection and diagnosis of cancer have a big impact in terms of disability and survival.  What’s more, there did not appear to be any harm associated with period health exams, including undergoing inappropriate tests or excessive costs.

So when should one have an annual health exam? 

  • If you have a family history of chronic diseases like diabetes or heart disease … I would recommend to do the exam ealrier after the age of 30.  Majority of heart attacks is due to diabetes and the early a diagnosis of diabetes is done the better is the outcome in terms of control and prevention of complications. 
  • Between the age of 40 to 50 if you have a family history of certain tumors where occult blood testing or flexible sigmoidoscopy would be helpful
  • Otherwise after the age of 50 should be a reasonable age to do the annual exam for an otherwise healthy individual.

As the saying goes: 

It Is Better To Be Early Than Sorry…

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5 Responses to “The Importance of An Annual Check Up”

  1. maxim Says:

    I am fortunate that the company where I worked with has this comprehensive plan for annual physical check up (inclusive of stress test).

    Wise companies should invest on this for their own benefit too. This way, their total hospitalization expenses would be minimised because there would be more focus on prevention.

  2. Doc Gerry Says:

    Agree Max… aside from providing comprehensive exams to limit costs from absenses, most companies now invest in gym within the company’s premises geared toward making sure the employees continue to remain healthy resulting in more productivity because of less illnesses.

  3. Juanita Says:

    This is why I read docgerrytan.ocm.Insightful post.

  4. Jody Says:

    I’m not a big fan of routine medicla exams. Based on the ones I’ve had, they’re unlikely to find anything I don’t already suspect and, as a woman, doctors (esp. male doctors) tend to treat me rather dismissively…which irritates me.

    Of course there are countless conditions which benefit from doctor-led diagnosis and treatment. …Of course. I wouldn’t begin to argue otherwise. I just don’t have any of them. On those rare occasions I have had something I’d like a doctor to investigate, I’ve been told there’s not much they can do.

    I’m currently just shy of fifty-years-old. I exercise pretty strenuously at least six days per week and eat a disturbingly-healthy vegan diet. I’m usally presumed to be in my twenties. I have no medical conditions (save symptom-free PCOS and alleged mitral valve prolapse).

    But, as can happen with anyone, I recently suffered a knee injury, which was likely a partial MCL tear. About fifteen years ago, I suffered what was likely a partial ACL tear. That self-healed in about three weeks. So, I did a better job of treating this injury, and I was back to normal activity inside of a week. (It was excruciating for two to three days, where I couldn’t walk at all.)

    My point is, just as with the previous knee injury, no doctor invention was needed, and I’m back to normal.

    So, you can imagine how concerned I was when I recently had a bout of several near-fainting spells, one morning.

    For the first time in nearly a decade, I went to a walk-in clinic to try to find out what was happening with me. (I moved recently and don’t yet have a local family doctor.) After about a twenty-minute wait at reception, and another twenty-minute wait in the exam room, I saw the doctor for about five minutes. He took my history and repeatedly got the details of the presenting symptoms wrong. Despite telling him I’d been up for hours and had a fantastic breakfast prior, he kept trying to imply the near-fainting was due to standing too quickly or from being hungry. (I’d been seated for all episodes, btw.) He also repeatedly asked if I might be pregnant. (I am not.)

    “Well,” he concluded, “it could literally be just about anything. But we’ve already sent off the blood samples for today, and we’re not open again ’til Monday. I suggest, if you really want to get to the bottom of this, you go to a hospital emergency room, and wait until they can see you.”

    Whenever my husband suggests I see a doctor for this or that, I usually reply, “Unless it’s something obvious, like a broken leg, or has a specific test, like HIV, or I’m spurting arterial blood, I’m not likely to be any better off. Worse, I’m likely to be treated as though I’m imagining the problem, or just wasting everyone’s time.” I didn’t take my own advice, and this is what happened.

    On the plus side, my symptoms did dissipate, and were gone by the following day. And my appointment did reveal normal blood-pressure and just a low-grade fever. That prompted me to buy a home blood-pressure kit, stethoscope (to listen for pulmonary abnormalities), and a new thermometer. (My digital thermometer, unused for years, was dead when I went to use it.)

    Given that near-fainting is so frightening when it happens out of the blue, I’d like to say I would still opt to see a doctor under similar circumstances. However, based on the fact this doctor essentially said, ‘What do you expect me to do,’ I suspect I am now more likely to take a wait-and-see approach, provided my temperature and BP are normal.

    I can honestly say I have had just one instance in my life here a physician actually benefited me. In my early twenties! I had a UTI, and received treatment for that. That’s it. (Even when my dog had bouts of lameness, various veterinarians and specialists were unable to diagnose her, including the vet. who saw her about two weeks before I noticed a swelling in her leg that I suspected was osteosarcoma…which it turned out to be.)

    So, in all, I have not been impressed. I’m not a big fan of routine exams, and have learned not to expect a diagnosis for anything that isn’t immediately life-threatening. I seem to do a edcent job on my own and, knock wood, self-heal anyway. I’m going to do my best to seek professional advice when I believe it’s something potentially serious. But I thought that about the near-fainting, and look where it got me… :-(

  5. David Says:

    I think you’re actually making a good argument for routine exams and a good Dr/patient relationship.

    Don’t you think your treatment would have been different if your Dr had your history going back a few years, knew you were a health nut, and knew that this was very unusual for you?


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