Should I Skip My Routine Physical? I Feel Fine!
By Becky Walton, RN
Earlier this year, on January 8, to be precise, my New Year's Resolutions were still being pondered. Thoughts swirled around the usual plans to exercise, eat healthier, lose weight... you know the drill.
Also on that day, an article appeared in the New York Times by Ezekiel Emanuel, MD, an oncologist and vice provost at the University of Pennsylvania. He presented a thought-provoking case for encouraging people to SKIP routine, general health checkups.
These visits are explained in the article as trips to a physician or health care provider (nurse practitioner or physicians assistant) NOT prompted by any particular symptom or complaint. He cites some studies which conclude that annual physicals aren't scientifically proven to reduce overall deaths or deaths specifically from heart disease or cancer. The author even calls the annual physical exam "worthless." He states he will still get his annual flu shot, a colonoscopy as indicated, and eat a balanced diet with routine exercise. He encourages others to do the same, but not go to the doctor without a specific complaint.
So ... is this good advice? Where I work at Gwinnett Medical Center, in the preadmission testing department, I spend every day working with people whose doctors are sending them in for surgery. This, plus my own background as a registered nurse got me thinking: Did I agree with this doctor’s article? And if not, what are some things to consider as we each are making plans about our own health?
1. Are you a doctor? If so, you have advanced training and knowledge (like this NYT physician/author) to assess and possibly detect medical issues as they arise in your body. So perhaps you might not need another MD looking you over without any specific complaints. If you are a doctor and clusters of symptoms arise like weight gain, dry skin, constipation, fatigue, and cold sensitivity, you may immediately suspect your thyroid gland has become underactive. But non-medical professionals might not make that link and a simple answering of questions or bloodwork at a routine physical might be the tests needed to catch and treat that condition.
2. Do certain diseases run in your family? If so, you may be genetically predisposed to having these diseases yourself one day. If your health care provider knows your family history, you may have screening tests done more frequently so you can have early detection of a disease. Often, early detection leads to better treatment results.
3. What's your cholesterol trend? Your blood pressure? How are your fasting blood sugars looking over time? If you don't know these answers, it might be because you aren't getting these things checked. Dangerously high blood pressure may cause no symptoms, but increases the risk for kidney damage, stroke and cardiovascular disease. Your primary care provider can track data over time from lab results and blood pressure readings and alert you to unfavorable changes and what needs to be done.
4. Does your insurance offer an incentive for an annual screening? Mine does. $250 goes in my pocket! That alone is a pretty solid reason to go, if you ask me!!
5. Do you know the current recommendations for screening tests and vaccines? I bet your doctor does. He/she can customize your health plan and notify you when you need to take action.
6. Ever known someone whose annual health exam caught a problem (big or small) that was already there but hadn't caused complaints yet? I do. My mother-in-law is active, overall healthy, and at 58 years-old, full of life and believes in getting routine physicals. This year, a routine chest x-ray and bloodwork showed results which had changed from last year's data. After a CT scan and biopsy, she was diagnosed with Stage 4 Renal Cell Carcinoma which had spread from the left kidney to all 6 lobes of her lungs. NO symptoms. NO complaints. Completely out of the blue! Her bone scan, thankfully, showed no cancer has spread to her bones.
So, should you only go to the doctor when, as Dr. Emanuel suggests, you have complaints? You are free to decide this for yourself. My whole family would now tell you that routine checkups are not "worthless."
Since my mother-in-law's cancer has been discovered, treatment began quickly and the prognosis HAS to be better than if she had sought care only once symptomatic. My husband recently said, "What if Mom had just skipped it this year?" EVERYONE who loves her is glad she chose YES.
How GMC Can Help
If it's time for a check-up, find a physician near you in our online directory of physicians.