Annual Physical Exam: Unneeded Expense?
New Research Adds to Debate About the Value of a Yearly Physical
Sept. 24, 2007 -- An annual physical exam is a tradition for many U.S.
adults, but it is not always necessary, according to a new study.
"I'm not advocating we should get rid of these visits," says
researcher Ateev Mehrotra, MD, MPH, assistant professor of medicine at the
University of Pittsburgh School of Medicine and a policy analyst at RAND
Rather, the preventive services and tests ordered at these exams that are
actually necessary often can be received -- and often already are -- at other
visits and times, says Mehrotra. The study is published in the Sept. 24 issue
of the Archives of Internal Medicine.
Using two national surveys, Mehrotra and his colleagues analyzed 8,413
doctor visits for preventive health exams (annual physicals) and preventive
gynecological exams -- which women schedule to get Pap tests and pelvic exams.
The doctor visits too place from Jan. 1, 2002, to Dec. 31, 2004.
Among the findings:
- About 44.4 million adults, or nearly 21% of the population, get a
preventive physical exam annually.
- About 19.4 million women, or about 18% of adult women, get a preventive
gynecological exam annually.
- Together, these account for 8% of all doctors' office visits. If every U.S.
adult got an annual physical, the U.S. health care system would need to provide
up to 145 million additional visits annually, the researchers estimate.
- Most preventive care, about 80%, was received outside the preventive exams,
when the patient saw the doctor for other reasons.
- The cost of providing both types of routine exams was about $7.8 billion --
almost the amount spent for breast cancer care in the U.S. in 2004.
- More than a third of the annual physicals in the study included testing
such as complete blood cell counts or urinalysis, which Mehrotra says are not
proven to improve patient outcomes when performed routinely and so may be
unneeded. Complete blood cell counts and urinalysis cost about $192
million a year in the study.
- The annual physicals and preventive gynecological exams, however, were the
most common avenue for getting certain crucial tests such as mammograms and Pap
- The number of adults getting the annual physicals varied by region,
reflecting differing beliefs and practices. "Those in the Northeast have a
60% increased chance of getting a physical compared to those on the West
Coast," Mehrotra tells WebMD.
(Do you get an annual
physical? Why or why not? Talk with others on WebMD's Health Café message