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Providers Weigh In: Are Annual Exams Really Needed?

Monday, March 2, 2015

A topic sweeping health care columns by storm is the debate to determine if the annual exam is really needed. Around 45 million Americans are likely to have a routine physical this year - just as they have for many years running. As factors such as time and cost play a role in general physicals, the elimination of the yearly exams, and transitioning into a system that focuses less on special visits, and more on services that are based on guidelines for specific groups that will provide key services.

john hickner - Family Medicine
John Hickner, MD, MSc
Head, Department of Family Medicine

Medical providers across the country have chimed in on this reoccurring debate; including Dr. Ezekiel Emanuel, oncologist at the University of Pennsylvania, and have identified the annual exam as "basically worthless."

Head of the Department of Family Medicine at UI Health, Dr. John Hickner weighs in saying, "In general, I agree that an "annual physical" for a healthy person with no chronic illness such as diabetes or hypertension, is not high value. The mantra for high value health care is "the right care for the right person at the right time." The new and I believe the correct way of thinking about the "annual physical" is what I call the "periodic health assessment."

With health care cost continuing to soar, the importance of a system that is tailored to the needs of specific patients has the potential to eliminate not only costs, but the time of physicians and those receiving exams. Hickner believes for people who "feel well" and don't have any chronic health problems, a periodic health risk assessment would be beneficial. He categorizes these health risks by the factors individuals have for getting sick or developing chronic illness. Risk factors such as, smoking, overuse of drugs and alcohol, obesity, lack of exercise, lack of immunizations and stress are all detectors in which Hickner can categorize "the right treatment for the right person at the right time."

History has played its role as physical exams have been recommended by physicians and medical organizations for more than 100 years, and as the debate and opinions circulate, Hickner rides the new wave of eliminating the routine annual exam yearly to healthy individuals with no risk factors. "Many people do need a yearly visit to the doctor or more frequently," Hickner says, "Once again, the visit is not for a physical exam most of the time. It is to assess your health status and help you develop a plan to address your health issues."