Survey renews debate about annual physicals by saying they may not help everyone

CHICAGO (AP) _ Even though a panel of experts has thrown cold water on the automatic need to get an annual checkup, physicians and their patients haven't always gotten the message, a new survey says.

Tuesday, June 28th 2005, 8:41 am

By: News On 6

CHICAGO (AP) _ Even though a panel of experts has thrown cold water on the automatic need to get an annual checkup, physicians and their patients haven't always gotten the message, a new survey says.

The survey, published Monday, found that while there's no evidence annual physicals for healthy people are useful, 65 percent of primary care doctors think they are necessary and nearly 9 out of 10 said they perform the exams.

Annual physicals have been the subject of a debate since at least nine years ago, when the U.S. Preventive Services Task Force declared there is insufficient evidence of any benefit from many of the tests often given with yearly checkups.

The task force is a respected non-governmental panel of researchers commissioned by Congress to develop evidence-based recommendations for medical care. It doesn't recommend for or against annual physicals, and neither does the American Medical Association.

The new survey was conducted in 2002 by Dr. Allan Prochazka and colleagues at the University of Colorado Health Sciences Center and appears in the Archives of Internal Medicine. In the review, many among the 783 doctors queried said routine exams should include tests that the task force says haven't been proven to prevent disease in healthy adults, including urine tests, blood-sugar tests for diabetes, and thyroid tests.

The most frequently recommended tests included complete blood counts, or CBCs, which check for conditions including anemia. Nearly 40 percent of doctors said those tests should be part of routine physicals, despite studies showing ``that there is very little yield'' from routine CBC testing, the researchers said.

Dr. Ned Calonge, the Preventive Services Task Force chairman, said he's ``bothered by the fact that so many people were ordering tests of unknown benefit'' and even potential harm if they lead to unnecessary invasive follow-up testing.

The study says routine physicals have been popular since the early 1920s, when an article in the Journal of the American Medical Association discussed their value in finding disease in apparently healthy people.

Technology and the development of screening exams, such as Pap tests for cervical cancer, mammograms and colon cancer tests, reinforced the idea that yearly exams are needed. Many medical groups recommend that these tests be done routinely, though not necessarily every year.

Dr. Arvind Goyal, a Rolling Meadows, Ill., preventive medicine specialist, called the task force ``a moving target'' whose broad recommendations don't always apply to individual patients.

For example, Goyal said he'd recommend an annual physical and exercise stress test for a 45-year-old man whose father died young of a heart attack _ but not for all 45-year-olds.

Still, yearly physicals have value even for healthy patients with no risk factors, he said.

``It's an opportunity to get to know your patients'' and make sure they're adopting lifestyle habits that will keep them healthy, he said.

Many health insurers pay for some periodic preventive screening but not annual physicals. An earlier study by the researchers who surveyed the doctors found that about two-thirds of consumers believe an annual physical is necessary, but only one-third would want one if they had to pay for it.