Monday, October 14, 2013

The Unnecessary Annual Physical


Danielle Ofri, ('Doctors' Bad Habits', Sunday Review October 6) after evaluating data that pointed to the lack of benefit in performing annual physical exams on young, healthy, asymptomatic patients, concluded that they were still worthwhile - at least for her.  Without citing any data of her own, the doctor concluded that an annual visit "establishes a solid doctor-patient relationship." We are not told, however, what her patients think about this medically unnecessary visit.  After all, they are asked to come to see her for no medically established reason, and in the process may be losing a day's work, or having to find someone to provide child care, etc.  I feel quite certain that a fee is involved as well.

Medicine should be practiced using well established guidelines.  Physicians often practice methods taught years ago, or practice by some "grandfathered" idea, if you will, that actually has no basis whatsoever in fact.  Evidence-based medicine is the path that all physicians should follow.  If they feel otherwise they should offer their patients a good explanation before he is asked to give up his time and spend his (or, more of then than not - our) money.

Dr. Ofri has decided that annual physicals are worthwhile despite data showing otherwise.  Why not semi-annual physicals, or quarterly physicals?  Why has "annual" become the standard for Dr. Ofri?  Maybe weekly phone calls would be even more beneficial for the doctor-patient relationship, Dr. Ofri.


4 comments:

Anonymous said...

I am a pediatric cardiology NP, and I agree with your general premise.

However, pediatric cardiologists as a whole are some of the worst violators of the BS "checkup" when one is not needed.

How many kids with fully repaired HLHS have you billed for BS "follow up" visits when they were completely asymptomatic and doing perfectly well?

How many kids did you force to drive 2 horus to see you for a follow up on aortic stenosis after repair that really didnt need to be seen?

Pediatric cardiologists make tons of money from these fake physicals that are completely unnecessary.

Carl Steeg said...

I agree with you completely!

Many kids have unnecessary routine evaluations. There should be evidence-based studies to determine how frequently such examinations are really medically indicated.

Roberta Katchen Stein said...

Hi Carl,
A number of years back, I would have agreed with you fully. But in 2006, an annual checkup saved my life! My internist found a small lump on my neck....which led to her diagnosis of Stage ! lymphoma. I had four rounds of chemo and a year ago was declared "cured." I lived to meet my youngest two grandkids and the wonderful man I will soon marry. So I don't think you can make such hard and fast statements.
It's wonderful to be in touch Carl...but hard to believe we're senior citizens!

Best wishes, Roberta Katchen STein
roberta18@comcast.net

Roberta Katchen Stein said...

Hi Carl,
A number of years back, I would have agreed with you fully. But in 2006, an annual checkup saved my life! My internist found a small lump on my neck....which led to her diagnosis of Stage ! lymphoma. I had four rounds of chemo and a year ago was declared "cured." I lived to meet my youngest two grandkids and the wonderful man I will soon marry. So I don't think you can make such hard and fast statements.
It's wonderful to be in touch Carl...but hard to believe we're senior citizens!

Best wishes, Roberta Katchen STein
roberta18@comcast.net