Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Why the annual physical still has value

James Marroquin, MD
Physician
November 14, 2013
53 Shares
Share
Tweet
Share

Ever since the days of William Osler, annual physical examinations with one’s doctor have been an accepted and expected part of health care.  But recently the practice has come under some criticism.  Given the dearth of studies showing that physicals lower the risk of death and hospitalization, some experts and organizations state that the annual physical should be abandoned.

I appreciate the effort here to question tradition and to consider if a commonly accepted practice truly has value.  Nonetheless, I believe that in the appropriate patient population, annual physicals serve important functions.  First, they ensure that people are up to date on health maintenance measures.  Screening for colon, breast, and cervical cancer is proven to save lives.

In my work in hospice and primary care, I have seen the tragedy of unnecessary suffering and premature deaths caused by a failure to do appropriate cancer-screening tests.  In my physicals, I also review patients’ immunization records to make sure they have been appropriately vaccinated against tetanus, diphtheria, pertussis, shingles, pneumonia, flu, and hepatitis A and B.  Doing so decreases their chance of suffering from these diseases and helps protect the surrounding community.  By screening for sexually transmitted infections I have detected HIV and syphilis, thereby enabling people to be treated at an early stage of the illnesses and preventing their spread into our local population.

Physicals are also a chance to see if a person has high blood pressure, elevated cholesterol, or type 2 diabetes.  People with these conditions often do not present with symptoms, but left untreated they can result in debilitating, costly outcomes such as heart attacks, strokes, blindness, and kidney failure. Finally, there is the issue of hip and vertebral compression fractures. By some estimates, nearly half of all women and 1/3 of men will have fragility fractures in their lifetimes.  Such fractures increase the risk of death and can end or limit many people’s ability to remain independent.  Effective screening and treatment for osteoporosis can markedly lower individuals’ risk of suffering hip or vertebral compression fractures.

Physicals are also occasions for addressing a person’s health habits and lifestyle choices.  Smoking, excessive alcohol intake, and drug use can be identified and appropriate help provided.  As part of my social history, I assess how much a person is exercising and inquire into the state of their nutrition.  Even if people already know it is good to be physically active and eat well, there is value in encouragement and reinforcement.

Physicals are a dedicated time for obtaining or reviewing a person’s entire health history, as well as his or her family’s health history.   This information is usually not addressed during other visits that focus on 1-2 specific problems.  Updating and discussing a person’s complete medical history helps put issues presented at other visits into a helpful context and framework.

Beyond all this, I view physicals as a time to get to know the patient as a person and what makes him or her tick.  My task is to help people live longer and better, but what are they living for?  Accordingly, as part of my social history, I usually ask patients something like “what gives meaning and purpose to your life?” or “what do you enjoy doing these days.”  Having a stronger grasp of a person’s values allows me to be a better guide in making health decisions.  And I believe there can be healing in sharing and receiving important, formative stories.

James Marroquin is an internal medicine physician who blogs at his self-titled site, James Marroquin.

Prev

Video review of surgeons: Can the logistical issues be overcome?

November 13, 2013 Kevin 11
…
Next

The chronically ill are those who need online services the most

November 14, 2013 Kevin 2
…

Tagged as: Primary Care

Post navigation

< Previous Post
Video review of surgeons: Can the logistical issues be overcome?
Next Post >
The chronically ill are those who need online services the most

More by James Marroquin, MD

  • a desk with keyboard and ipad with the kevinmd logo

    Physicians should recognize patients’ spirituality

    James Marroquin, MD
  • a desk with keyboard and ipad with the kevinmd logo

    Health and well-being are holistic concepts

    James Marroquin, MD
  • a desk with keyboard and ipad with the kevinmd logo

    Some patients don’t expect doctors to be miracle workers

    James Marroquin, MD

More in Physician

  • The essence of health narratives, including poetry

    Arthur Lazarus, MD, MBA
  • Discover the power of patience

    Diane W. Shannon, MD, MPH
  • Doctors rediscover joy in practicing medicine, on their own terms

    Kim Downey, PT
  • Physician return-to-work policies

    Deepak Gupta, MD
  • How my patients’ Zoom backgrounds made me a better doctor

    Joseph Barrera, MD
  • Understanding reproductive rights: complex considerations

    Anonymous
  • Most Popular

  • Past Week

    • Challenging the diagnosis: dehydration or bias?

      Sydney Lou Bonnick, MD | Physician
    • A teenager’s perspective: the pressing need for mental health days in schools

      Ruhi Saldanha | Conditions
    • Understanding reproductive rights: complex considerations

      Anonymous | Physician
    • COVID-19 unleashed an ongoing crisis of delirium in hospitals

      Christina Reppas-Rindlisbacher, MD, Nathan Stall, MD, and Paula Rochon, MD | Conditions
    • Air quality alert: Reducing our carbon footprint in health care

      Shreya Aggarwal, MD | Conditions
    • When physicians are disrespected [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Medical gaslighting: a growing challenge in today’s medical landscape

      Tami Burdick | Conditions
    • I want to be a doctor who can provide care for women: What states must I rule out for my medical education?

      Nandini Erodula | Education
    • Balancing opioid medication in chronic pain

      L. Joseph Parker, MD | Conditions
    • Unveiling excessive medical billing and greed

      Amol Saxena, DPM, MPH | Policy
    • The erosion of patient care

      Laura de la Torre, MD | Physician
    • I’m a doctor, and I almost died during childbirth

      Bayo Curry-Winchell, MD | Physician
  • Recent Posts

    • When physicians are disrespected [PODCAST]

      The Podcast by KevinMD | Podcast
    • Addressing dual diagnosis needs in addiction treatment

      Susan Hertz Berrick, EdD | Conditions
    • The essence of health narratives, including poetry

      Arthur Lazarus, MD, MBA | Physician
    • Discover the power of patience

      Diane W. Shannon, MD, MPH | Physician
    • Doctors rediscover joy in practicing medicine, on their own terms

      Kim Downey, PT | Physician
    • End-of-life ethics and antibiotic use [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 31 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Novavax's Updated COVID Shot Authorized by FDA
  • SBRT Noninferior to Conventional RT for Intermediate-Risk Prostate Cancer
  • Mixed Bag for Early Metformin in Gestational Diabetes
  • FDA Advisors to Consider DFMO Maintenance for High-Risk Neuroblastoma in Kids
  • Adding Tirzepatide to Basal Insulin Cuts HbA1c in Poorly Controlled T2D

Meeting Coverage

  • SBRT Noninferior to Conventional RT for Intermediate-Risk Prostate Cancer
  • Mixed Bag for Early Metformin in Gestational Diabetes
  • Adding Tirzepatide to Basal Insulin Cuts HbA1c in Poorly Controlled T2D
  • Low Relapse Rates With Twice-Yearly Schizophrenia Treatment
  • Menopause Can Negatively Affect Women's Careers
  • Most Popular

  • Past Week

    • Challenging the diagnosis: dehydration or bias?

      Sydney Lou Bonnick, MD | Physician
    • A teenager’s perspective: the pressing need for mental health days in schools

      Ruhi Saldanha | Conditions
    • Understanding reproductive rights: complex considerations

      Anonymous | Physician
    • COVID-19 unleashed an ongoing crisis of delirium in hospitals

      Christina Reppas-Rindlisbacher, MD, Nathan Stall, MD, and Paula Rochon, MD | Conditions
    • Air quality alert: Reducing our carbon footprint in health care

      Shreya Aggarwal, MD | Conditions
    • When physicians are disrespected [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Medical gaslighting: a growing challenge in today’s medical landscape

      Tami Burdick | Conditions
    • I want to be a doctor who can provide care for women: What states must I rule out for my medical education?

      Nandini Erodula | Education
    • Balancing opioid medication in chronic pain

      L. Joseph Parker, MD | Conditions
    • Unveiling excessive medical billing and greed

      Amol Saxena, DPM, MPH | Policy
    • The erosion of patient care

      Laura de la Torre, MD | Physician
    • I’m a doctor, and I almost died during childbirth

      Bayo Curry-Winchell, MD | Physician
  • Recent Posts

    • When physicians are disrespected [PODCAST]

      The Podcast by KevinMD | Podcast
    • Addressing dual diagnosis needs in addiction treatment

      Susan Hertz Berrick, EdD | Conditions
    • The essence of health narratives, including poetry

      Arthur Lazarus, MD, MBA | Physician
    • Discover the power of patience

      Diane W. Shannon, MD, MPH | Physician
    • Doctors rediscover joy in practicing medicine, on their own terms

      Kim Downey, PT | Physician
    • End-of-life ethics and antibiotic use [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Why the annual physical still has value
31 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...