A new study from England shows that a routine physical exam does not benefit patients as regards their longevity, or in appreciably reducing risk of heart disease or cancer.

This is not a surprise and is good news really.  Why?  Because just doing an examination will have little benefit if people don’t head the warnings to eat better, exercise more, and smoke less.  Unfortunately, the examination time does not promote these behavior changes.

That said, I do think a physical exam is a moment to take stock of these issues and consider them in the context of general health, and as well, allows us to reassure patients that ‘at this time, you look fine and healthy’ and that reassurance is worth a lot to each of us in regards to peace of mind.

So….don’t stop getting your exams.  I think doing them at yearly or every other year intervals, still provides a psychological benefit, as well as a time for certain individuals to identify issues and make changes.

http://www.bmj.com/content/345/bmj.e7191

This week’s Sunday New York Times Sunday Review Section had a front page article on the pro’s and con’s of getting a physical exam.
The article correctly pointed out that there is little scientific evidence supporting the yearly physical exam and it went on to focus on the costliness of unnecessary testing that can result in findings that vary from normal but that don’t indicate disease. Rather then focusing in on a yearly exam, they discuss a making sure that interval testing is done, such as colonoscopy, mammograms, etc….and follow-up on immunizations that are appropriate for adults.
All of this is reasonable and certainly if you wish to take this approach to your general health, I think it is a good one. That said, there is great solace and comfort in having a physical exam that shows you to be in good health and that reassures you that there are no underlying issues developing ‘below the radar’. Such reassurance is my ‘stock in trade’ and it much of what each of us seeks when we see the doctor–to be told that we are healthy and fine and do not need to worry about any health concerns. In addition, we do get the time to reflect on our general health habits and to reaffirm our commitment to proper exercise, diet, and reduction of bad habits.
I think of your health as a giant pie (yum!)…..with much of that pie, 90%, out of your control. That portion is composed of your genetics and environmental factors our of your control. Of the 10% that remains, much of that, the portion within your control, is taken care of by good habits of exercise, diet, weight management, and the elimination of bad habits.
And the last ‘sliver’ of pie, small though it is, is made up of the things we can identify early and treat or alter before they become an issue.
So….the physical exam still has a role for each of us, and it’s importance is based on how we perceive our health and how important staying on top of preventive efforts is to us personally.