Diagnosing the Annual Medical Checkup

Wednesday, August 21, 2013

doctor visit (Alex Proimos/flickr)

The annual checkup is a mainstay in American medicine, and has long been considered the front line in preventative care. But doctors and policy advocates are starting to question just how effective the annual visit really is.

Some doctors say the annual visit is an opportunity to look for hidden abnormalities in people who otherwise feel healthy. But cellular abnormalities are actually quite common.

The real danger, some say, is treating a person for an abnormality that could potentially be benign. While treating the very early stages of a disease could prevent worsening conditions, that same treatment could also cause a person unneeded harm. Not every abnormality grows into a full-fledged disease.

Dr. Gilbert Welch is a general internist at the White River Junction, Vermont VA and a professor of Medicine at the Dartmouth Institute for Health Policy and Clinical Research. He's also the author of "Over-Diagnosed: Making People Sick in the Pursuit of Health" and joins The Takeaway to discuss when to use preventative medicine, and his suggestions for improving the annual checkup.




Dr. Gilbert Welch

Produced by:

Fannie Cohen

Comments [5]

Su O'Neill

I think the annual visit is extremely important. Blood tests can tell the doctor a lot and he can find things that need following up on. If your family member died of a heart attack or had cancer get to the doctor! My usual is once a year and one year I went to the doctor 12 times because of back pain and bloating and I was blown off every time. I was treated like a drug addict because I need a half a vicodin a day for back pain. Insurance only covered one blood test a year so it wasn't time for that yet. When we did finally do it my white count was sky high and I was sent for imaging and found I had stage 3 cancer. I also have seen people put through un needed tests but it proved that there was nothing wrong and this took a load off of the people's minds. I WOULD NEVER TAKE UP MY MD'S VALUABLE TIME TELLING HIM I GOT A NEW BIKE AND MY HUSBAND HAD A BUG IN HIS ASS. GO TO A SHRINK FOR THAT.

Aug. 21 2013 04:46 PM
Cheryl from Eureka, MT

I think annual checkups are very important. Just once a year, I go to my doctor and make sure all my body parts are in order. We go over all the little things I otherwise never think about. We review medications, both prescription and over the counter. We go over life events. We usually run blood tests, but not many. My appointments run about 1-1.5 hours.

When I listened to Dr. Welch, he, in fact, advocates exactly what I do. So I don't know what other doctors do at annual checkups, but I think his approach, at least how it was presented here, is quite misleading. He advocates checkups like mine, not necessarily annually. I think 1.5 hours once a year to have all your health and lifestyle concerns is not burdensome at all.

After 11 years and 11 doctor visits, I experienced some minor discomfort that I felt was "not normal". Based on this feeling, I was sent for some tests and was diagnosed with Primary Peritoneal Cancer. My doctor arranged the surgery in Washington, the chemo in Whitefish, physical therapy in Eureka. I had not actually seen her during all this. So after 11 uneventful annual checkups, my doctor knew enough about me to do exactly what was needed when I needed it.

I think annual checkups are worth it!

Aug. 21 2013 01:51 PM
Teresa from Texas

Your discussion did not take into account those of us taking prescription medications. I would love to see my doctor less frequently than once a year, but because I have to take a statin to keep my cholesterol level under control and my doctor declines to prescribe more than a year of pills at a time, I am forced to have an annual check-up. By the way, in all of years I have had the annual exam, nothing detrimental has been revealed to date. Is this a waste of medical dollars? - yes, I believe so.

Aug. 21 2013 01:18 PM

Annual check ups are important when you have children, because as a mother or father the children count on you to be healthy, and it's easy to let your own health slide while keeping track of annual check ups and shots/boosters for your children, but . . . there comes a time when it becomes a less productive expenditure of time. I'm retired, age 66. To many doctors want to run tests, and hand out antibiotics like they are water, but often we suffer from a virus, or eat unhealthy junk. No one needs a doctor to tell them that - you either will eat and exercise or you won't. Eating the best produce, fruits and veggies with minimal amts of meat. Walk and lift weights a few times per week - don't join a gym but exercise at home. Get a flu shot if you want at your local drug store, basically, look after yourself and stop thinking you 'should' live forever.

Aug. 21 2013 01:12 PM
Julia from worcester, ma

I agree you Dr. Welch a million times. Keep up the good work I will buy your book. I'm waiting for this philosophy to become mainstream before I dare to go back to the doctor for any kind of wellness check up.

Aug. 21 2013 11:44 AM

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