About one-fifth of U.S. adults get an annual physical. But increasingly, research suggests that it's not necessarily a critical appointment to keep. “A number of randomized controlled trials now show that these yearly exams don’t improve people’s health or health outcomes,” says Ateev Mehrotra, M.D., an associate professor of health care policy and medicine at Harvard Medical School and a hospitalist at Beth Israel Deaconess Medical Center. One 2012 review of over 180,000 people, published in the British Medical Journal, for example, found that the practice didn’t do anything to reduce rates of disease or dying from disease. As a result, groups like the Society of General Internal Medicine no longer recommend physicals for people who are healthy, without any symptoms of illness.
Part of the concern, says Christine Laine, M.D., editor in chief of Annals of Internal Medicine and a senior vice president at the American College of Physicians, is that during an annual exam, your doctor may order tests — such as blood or urine tests, or an electrocardiogram (EKG) — that aren’t necessary in otherwise healthy people. “If your doctor finds something they didn’t need to find, they may end up ordering more tests, which is expensive and can cause you to worry,” she notes.
Instead, if you’re otherwise healthy, with no chronic conditions, you’re best off simply just seeing your physician once a year, or once every two years, for what's come to be known as a wellness check-in or wellness exam — kind of like a physical but without the battery of tests. “Just like infants have well-baby visits, it makes sense to see your provider to make sure you’re up to date on all your needed screening tests, as well as to discuss basic preventative lifestyle strategies like eating healthfully, exercising regularly and getting enough sleep,” Laine says.
But that’s not to say that you should skimp on the doctor visits. Where people go wrong, especially as they age, is putting too much stock in physicals and not enough emphasis on taking charge of chronic conditions. “As you get older there are specific health conditions, such as high blood pressure or type 2 diabetes, that you'll need to monitor with more frequent visits,” says Michael Hochman, M.D., assistant professor of clinical medicine and director of the Gehr Family Center for Implementation Science at the Keck School of Medicine at the University of Southern California.
But if you’re already in your doctor’s office several times a year, you don’t need to schedule a separate wellness exam, too. “During these visits your physician should be able to address any other concerns,” says Laine. “Hauling someone back in for another visit to address preventative health isn’t convenient for patients.”
There is one advantage to scheduling an actual annual wellness visit, Mehrotra notes. You won’t have to shell out an insurance copay, since most plans pay for one of these exams each year. “If you’re in your doctor’s office two to three times a year to monitor a condition, for example, it’s perfectly reasonable to make one of those visits your so-called wellness exam. But you don’t need those head-to-toe exam elements, including annual blood work. Instead you should spend any additional time discussing ways to improve your lifestyle, and any other concerns.”
To help you sort through what you really do — or don't — need every year or so, we've highlighted tests you likely can skip, followed by screenings you really should schedule.
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Four Tests You Likely Don't Need
- Pelvic exams There’s no evidence that pelvic exams help detect ovarian cancer or allow doctors to ease benign problems such as fibroids or cysts by treating them earlier, according to a 2014 review in Annals of Internal Medicine.
- Chemistry screens These are groups of tests that are ordered (often when you go in for a physical) to determine your general health status — for example, electrolytes, proteins, and kidney and liver function. But these tests can generate false positives, says Laine, like suggesting you have a liver abnormality when you really don't, and sometimes they aren’t covered by health insurance. There are certain people who should get specific types of blood work each year; someone who is on a diuretic for high blood pressure, for instance, should get his kidney function and potassium levels checked annually, since these types of medications can affect both. But there’s no need to test things like thyroid hormone levels unless someone is showing symptoms of thyroid disease. “If your physician hands you a slip for blood work, you should always ask what tests they are ordering and why they want you to have them, to make sure they’re really necessary,” says Laine.
- Urinalysis Unless you have signs of a urinary tract infection, such as frequent burning while urinating, there’s no need to do this test, says Laine. You may end up being incorrectly diagnosed with a UTI and be treated with antibiotics even though you don’t have an infection.