Is an Annual Check-up Really That Necessary?

 

As Benjamin Franklin famously stated, "An ounce of prevention is worth a pound of cure." That axiom applies to your health, as well. Perhaps the hope of preventing health problems or catching them early is why most people get an annual checkup with their family doctor. Over the years, the annual checkup has changed to put greater emphasis on wellness in addition to regular screenings for health issues based on age, gender, risk factors and more. Knowing what you need from an annual checkup can be complicated, so we asked west suburban physicians to answer a few questions.

Do I Need an Annual Checkup?

Family physicians advocate for annual exams as a way to build a long-lasting relationship with your primary care doctor, who then can identify and monitor any health concerns throughout your life. In fact, family physicians can and do treat the entire family, from children to parents to grandparents, with the training to handle a wide range of health issues. 

"The most rewarding aspect of my job is that I get to have a nice conversation with 20 people a day and get to know them over the years," says Dr. Brett Hampson, who practices family medicine with DuPage Medical Group in Westmont. He explains that family doctors are trained to "do all specialties in one practice," although they do call upon specialists when needed. He believes the benefits of a strong physician/patient relationship become even more important over time, as more health concerns appear and risk factors increase with age. 

So it may surprise you to learn that recent medical research questions the benefits of an annual physical for healthy people. In fact, the Society for General Internal Medicine’s position is that physicians should not "routinely perform annual general health checks that include a comprehensive physical examination and lab testing." Physicians and researchers who advocate for doing away with the annual physical point to its high costs, questionable health outcomes, unnecessary tests that can lead to false positive results, and the stress involved for the patient. 

It’s a controversial assertion that goes against decades of medical practice, and it’s not likely to go over well with the estimated 44 million Americans who faithfully get annual checkups. A survey by the Kaiser Family Foundation found that fully 92 percent of U.S. residents say it’s important to get an annual physical, while 62 percent report actually getting the exam.

Dr. Hampson sees both sides of the argument. "It’s a nice opportunity for us to assess your overall health. There is no downside to checking on your health. At a minimum, patients can ask questions." That said, he does concur that the annual exam may not be absolutely necessary for healthy individuals. But for people who are on maintenance medications, an annual visit is a necessity, since the longest period for which a prescription can be written is one year, and the effectiveness of any drug needs regular monitoring.

For people with ongoing health concerns like diabetes or heart problems, a regular visit is absolutely necessary. "Physicians like to see people regularly to treat chronic conditions," says Dr. Laura Norman, a family physician with the AMITA Woodridge Outpatient Center. "Then people are much less likely to have flare-ups, if the condition is managed appropriately."

Dr. Amy Arialis, who specializes in family medicine at Advocate Health Center in Lombard, believes most people will benefit from an annual exam. "Technically, your annual exam should be for prevention and wellness, not acute complaints," she explains. "Most people see the annual checkup as a no-brainer for kids," whose annual wellness visit and immunizations are required by schools.

What Should I Expect at the Annual Checkup?

If the prospect of an annual physical brings unpleasant thoughts of sitting on a chilly table in an ill-fitting hospital gown, take heart. Although some parts of the checkup require a bit of poking and prodding, the main goal is to assess your overall health and to determine what health screenings may be needed based on your age, gender, family medical history, and other risk factors. "We give a full head to toe evaluation, but we start with a conversation, going through every body system and asking if the patient has concerns with each," says Dr. Norman. "We want to address any acute concerns." She sees preventative medicine as "the most important thing." Your primary care doctor will want to talk through your medical history, review any medications you are taking and your vaccination history, and recommend screenings and tests based on your personal health status."Baseline weight, blood pressure and lab results help with longitudinal risk assessment," notes Dr. Arialis. She observes that it can be very difficult for patients to sift through health information on their own to figure out what they might need, especially if they look up information online. "It’s not all good, evidence-based recommendations," she says of internet sources. 

"Medicine and science are super dynamic," she adds. "Not only do the screening recommendations change but recommending entities don’t always have consensus." Among the recent changes to screening guidelines is the Pap smear, which used to be conducted every year, but now is recommended only every three to five years for most women. Arialis also explains that because colon cancer is now appearing at a younger age, the recommendation for the first colonoscopy is being pushed back from age 50 to age 45. However, she says, there are "other non-invasive ways of screening for colon cancer available by prescription." 

The timing for many screenings also depends on your family medical history, which may put you at higher risk for such conditions as breast, ovarian and colon cancer, and heart attacks or strokes, particularly if a close family member suffered an attack at an early age. As a result, it’s best to let your family physician guide you on when and what screenings would be beneficial for you.

What Do I Need to Do to Prepare for My Checkup?

"It’s very helpful to have your medications on file, especially if you are a new patient, as well as a full vaccination history," advises Dr. Norman. Screening blood tests are typically ordered for patients over age 35, unless a specific health concern requires them earlier. If blood tests are likely to be ordered, she says, "It helps to come to the appointment fasting." Such lab tests as glucose, cholesterol, liver function, and the basic metabolic panel are only accurate if you haven’t eaten for a certain number of hours before the test, usually eight to 12, depending on the test. The easiest way to do that is schedule an early appointment so your sleeping hours count and you only miss breakfast and your morning coffee. Of course, if you haven’t fasted, you can always schedule those tests at a later date. 

"For me, I address any issues the patient has. Most people come in with a list of questions," says Dr. Hampson. "The annual exam allows doctors more time to talk." He points out that an important component of the checkup is assessing the health risks of various lifestyle behaviors, such as diet, exercise, smoking and alcohol history. "If your doctor tells you to quit smoking, you’re more likely to quit." 

"If you have any concerns, ask your doctor," Dr. Norman says. "There’s never a silly question. We want to make sure we are focusing on what concerns you. Then we can work as a team to determine if medication or some kind of therapy is needed."Above all, family physicians agree that establishing a relationship with a primary care doctor is critical to ensuring your long-term health. Occasional visits to an urgent care clinic can’t give the same continuity of care, nor can their clinicians spend the time needed to understand the person’s overall health concerns. Despite the brewing controversy, an annual physical may still be the best way to stay on the road to good health.

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