What are the risks and benefits of having a comprehensive annual physical exam and routine blood tests?
The model of an annual physical examination Events Almost a century ago in American medicine, but recently, many health officials have “all agreed that routine annual checkups for healthy adults should be abandoned” – yet the majority of the public still is expected not only a comprehensive annual physical exam, but also extensive routine blood tests. “Given the gap between patient enthusiasm for and [the new] Skepticism of guidelines about annual head-to-toe exams, what are Doctors Do? “As I discuss in my video Is it worth doing an annual physical exam?“First we have to raising Patients about preventive practices with proven and unproven benefits. “For example, currently the only routine blood test recommended According to the USPSTF, the official guidelines for preventive medicine, cholesterol is cholesterol.
The reason “why many doctors continue Performing annual exams of patients’ hearts, lungs, abdominal muscles, and even reflexes, and continuing to order some of the tests that have been found to be ineffective or even harmful, is because the patient may otherwise remain unsatisfied with the visit. “Proofs suggests The more thorough doctors are (that is, the more physical and laboratory tests they do), the better patients will feel about their health and their doctors. ” So that you are like “clinical placebo maneuvers … But instead of doing unnecessary (and sometimes contraindicated) physical exams and laboratory tests during an annual visit, perhaps doctors should save some of the time saved by.” tell their patients why they don’t examine their stomach, heart and lungs ”- that is, why won’t they just go through the movements like a witch doctor.
“Most importantly, we have to raising us about the dangers of overdiagnosis…. There will always be a small possibility that our exam will discover a silent, potentially fatal cancer or aneurysm. Unfortunately for our patients, these random, life-saving events are far less common than the false positives that lead to invasive and potentially life-threatening tests, ”wrote a Cleveland Clinic doctor. He told a story about his own father who had himself examined. Can’t hurt, can it? His father’s doctor believed he had an aortic aneurism and ordered an ultrasound for the abdomen. Can’t hurt, can it? His aorta was fine, but something about his pancreas looked suspicious, so a CT scan was ordered. Well, that can hurt – it’s a lot of radiation – but luckily his pancreas looked fine. But … what’s that about his liver? It looked like cancer, which made some sense since his father had worked in the chemical industry. Realizing how ineffective treatment for liver cancer was, he realized he was going to die.
However, his daughter was unwilling to give him up and convinced him to see a specialist. Maybe he could live a few more years if they cut it out. But first they had to do a biopsy. The good news was he didn’t have cancer. The bad news, however, was that it was a benign mass of blood vessels. When they stuck a needle in for a biopsy, he almost bled to death. It took ten units of blood – and ten units is about all you have! This led to pain, i.e. morphine, i.e. urinary retention and thus a catheter, but luckily no infection. Just one bill for $ 50,000.
The frustrating thing is that there was no misconduct or anything like that in the whole terrible sequence. Logically, each step led to the next. “The only way to prevent this [life-threatening] The result would have been to forego the initial physical exam ”- the“ exam ”that couldn’t hurt, right?
“Then why do we keep examining healthy patients? First of all, we get paid for it. “His father’s first doctor only got about a hundred dollars, but just think of all the“ downstream income ”for the hospital and all the specialists. Overdiagnosis is big business.
“Too many patients bear the cost and harm of unnecessary tests and procedures ”, but without annual check-ups, we doctors would miss all these opportunities for“ open communication and interpersonal continuity… ”. Is that so? In this case, one doctor replied, if you want communication, why not just take your patients to lunch?
“Of course, such lunches should be preceded by a discussion of informed consent that enables potential diners to understand the risk of being infantilized, addicted, and potentially receiving unnecessary and harmful diagnostic and therapeutic interventions as a result of grilled cheese and soup” – in particular I would add if you feed your patient grilled cheese after you have already recorded your first such “unnecessary and harmful” act!
So if you’re not experiencing symptoms or problems, should you even get an annual check-up? That was the subject of my last video Is it worth having annual health checkups?.
Should all children have their cholesterol checked?, also? Check out the video to find out!
Check out this video Find Out If Your Doctor Is Taking Money From Drug Company.
I sometimes trip over these peripheral issues and fall into various rabbit holes. For example, I have quite a few videos on various diagnostic tests such as mammograms. I don’t want to be too far off nutrition, but when I learn something new and interesting – especially when there are conflicts of interest trying to cloud the water – I feel compelled to share in order to improve the record.
Michael Greger, MD
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