That Health Rules

Do 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:

_______________________________________________________

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.

_______________________________________________________

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…