Many American physicians still recommend an annual physical exam. In Canada, this practice is not viewed as necessary.
I recently did a complete physical, after finally being assigned a physician through the health system in Quebec. I did all the necessary blood tests. I was in good health, so I was not given a date for another appointment. “Come back if you have a problem!” the doctor told me.
Although annual physical exams are not shown to be effective, many people still believe they need to see the doctor every year, for early prevention and to make sure nothing is wrong.
Dr. McDougall writes:
My parents believed so much in the healing powers of medicine that as a child I was subjected to annual physical examinations at the University of Michigan Medical School. For nearly half a day several highly trained professionals examined my body looking for the slightest indication that I might have the beginnings of a potentially fatal illness, such as cancer. An analysis of my body fluids and excrements provided the final proof that I was in excellent condition – likely to survive until next year.
You might think this exam to be prudent action by my parents, showing their love and concern; but these expensive intrusions did nothing to prevent me from suffering a debilitating stroke at the age of 18, having a cholesterol level of 335 mg/dl at 22, gaining 50 extra pounds of fat by the time I was 24, and undergoing major abdominal surgery when I was 25 years young. Nor is an annual physical examination likely to make a meaningful difference in your life – and that is why major health organizations worldwide recommend against this customary checkup.
In 1979, the Canadian Task Force on the Periodic Health Examination was the first organization to recommend against annual physical examinations. Since then, the American College of Physicians, the American Medical Association, the U.S. Preventive Services Task Force (USPSTF), and the U.S. Public Health Service have all agreed that routine annual physical exams for healthy adults should be abandoned and instead doctors should focus their attention, during the time spent with their patients, on the few problems that they can really help.
There are a few reasons why I don’t see a “family doctor” every year, or even do yearly blood tests.
“Early detection” is not prevention. Looking for lung cancer by undergoing various tests is NOT prevention. True lung cancer prevention is not smoking — among other things.
I am a little apprehensive about the dangers of early detection. Worse even, screening tests over-diagnose and over-treat people; they can be hazardous to your health. The recent book by author Dr. H. Gilbert Welsh explains the reasons why. It’s called: Overdiagnosed: Making People Sick in the Pursuit of Health.
The physicians I met rarely gave me useful advice. Their goal was to look for something wrong, or address a concern — in both cases with a drug prescription. By following the rituals of the medical profession, the act of the medical consultation must end with the prescription of a drug. It’s a rare occasion to walk into a medical office with a complaint and leaving without a prescription for some drug.
I’m not at a risk factor for any lifestyle-related disease, due to my diet and lifestyle. This is not to say that I can’t get sick. But getting sick for reasons other than diet and lifestyle cannot be avoided through an annual physical examination.
The most important reason why I don’t see a family doctor every year is that I prefer to stay out of the medical system as much as possible.
There are two ways in which you can become involved in the medical system. The first one is obvious: if you exhibit signs and symptoms of a problem, so you seek help or advice. The second one is, doctors come to you and find something wrong with you.
Doctors are busy. They don’t have much time. They only look for a few things. They don’t ask you a lot of questions. They’re busy treating the symptoms, rather than the root cause. If your blood pressure is high, they will prescribe you blood pressure medication — never trying to identify what caused the high blood pressure in the first place.
As I’ve mentioned in the beginning of the article, what I’m saying is not even controversial. In Canada, we don’t do yearly physicals unless a person has existing health problem or is old enough.
This doesn’t mean that you should not be proactive in taking care of your health or that you should never see a doctor.
Here’s what I do.
Every so often, I take blood tests. Some people like to do it every year or every six months, but I think that unless you have an existing health problem, that it’s unnecessary to test that often. Make sure your diet is healthy rather than obsessing about taking regular blood tests and worrying about the results! That being said, in the first few years of changing your diet, it might be useful to get blood tests done at regular intervals, to see how this new diet is working for you.
I monitor my blood pressure myself, at home. Blood pressure is a better indicator of overall health, and you can do it safely at home, without the “white coat” syndrome, whereby the numbers are elevated due to the stress of a doctor’s visit.
I will get a physical exam done by a physician, but not every year. If I have a question, I can contact my doctor.
Of course, worrisome symptoms should be a good reason to consult. And starting at a certain age there are specific screening tests that might be worth it. It’s best to ask a more conservative doctor — one who does not push all of the latest and greatest tests. And indeed, a physician who recommends a yearly physical when you’re still (relatively) young with no existing health problems might not be so conservative, and it might be a good idea to find another one!