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annual physical examination; annual health examination

Despite a lack of evidence to support cost-effectiveness of annual physical examination, both patients & physicians report enthusiasm for this practice. Indications: - may strengthen provider-patient relationship - may reduce cardiovacular risk factors - may increase receipt of preventive services [5] Contraindications: relative - unlikely to benefit patients 18-64 years of age & might lead to unnecessary tests & treatment [2,3,4] - no reduction in mortality [5] History: - USPSTF endorses routine screening for - depression - hypertension - tobacco - alcohol - USPTF endorses screening for diabetes mellitus in adults 35-70 years who are overweight or obese Laboratory: Primary care physicians endorsed to following routine laboratories: 1) lipid panel (48%) - indicated in adults 40-75 years to calculate 10 year cardiovascular risk 2) complete blood count (39%) 3) urinalysis (44%) 4) blood glucose (46%) 5) kidney function tests (32%) USPSTF endorses - 1 time screening for HIV1 in all persons age 15-65 years* - 1 time screening for hepatitis C in persons age 18-79* * regardless of risk

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primary care

General

physical examination

References

  1. Journal Watch 25(16):125-26, 2005 Prochazka AV, Lundahl K, Pearson W, Oboler SK, Anderson RJ. Support of evidence-based guidelines for the annual physical examination: a survey of primary care providers. Arch Intern Med. 2005 Jun 27;165(12):1347-52. PMID: 15983282 - O'Malley PG, Greenland P. The annual physical: are physicians and patients telling us something? Arch Intern Med. 2005 Jun 27;165(12):1333-4. No abstract available. PMID: 15983280
  2. Rubin R Debating Whether Checkups Are Time Wasted or Time Misused. JAMA. Published online June 19, 2019. PMID: 31215986 https://jamanetwork.com/journals/jama/fullarticle/2736664
  3. Krogsboll LT, Jorgensen KJ, Gotzsche PC General health checks in adults for reducing morbidity and mortality from disease. Cochrane Library. Jan 31, 2019 PMID: 30699470 https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD009009.pub3/full
  4. Bouck Z, Calzavara AJ, Ivers NM et al. Association of low-value testing with subsequent health care use and clinical outcomes among low-risk primary care outpatients undergoing an annual health examination. JAMA Intern Med 2020 Jun 8e201611 PMID: 32511668 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2766917
  5. Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022