Death to the Annual Physical?

Dr. Zeke Emanuel, opinionator and recent White House policy advisor, weighed in last week with his own New Year’s resolution: to skip the annual physical exam, a time and money waster that potentially does more harm than good.

Emanuel’s op-ed in the New York Times made a lot of good points, mostly about the inability of modern medicine to reliably detect hidden diseases that are not sending out clear signals of pain and distress to the conscious brain.

This is a perennial debate, ever since Canadian health authorities in 1979 reviewed all the evidence and found no benefit to the annual checkup. Since then, there still is no clear evidence of value in the annual physical for someone with no symptoms.

A couple of years ago, a similar piece in the Times drew some interesting reader responses, including this one from a primary care doctor, who made the point that doctors like her use the annual physical for a health coaching session and update on any chronic ailments the patient has. That can be valid, depending on your own situation.

The main bottom line, though, is to pay attention to your body and get help when it sends weird and persistent signals. Denial, especially for us males, is more likely fatal than not getting an annual checkup when we’re feeling fine.

There are a few preventive things we all should do: get an annual flu shot and a colonoscopy every 10 years, get other vaccines like shingles, keep track of your blood pressure now and again. But if your health is good, you’re not going to improve it by going to your doctor just for a checkup.

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