The Annual Physical Examination: Needless Ritual or Necessary Routine?
Authors: Christine Laine
Journal: Annals of Internal Medicine (2002)

Editorials7 May 2002The Annual Physical Examination: Needless Ritual or Necessary Routine?Christine Laine, MD, MPH, Senior Deputy EditorChristine Laine, MD, MPH, Senior Deputy EditorSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-136-9-200205070-00013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Imagine that a 45-year-old married, premenopausal woman with no chronic or acute medical problems, unremarkable family history, normal cholesterol level 2 years ago, and no tobacco use presents to you requesting an “annual physical.” You ask whether she drinks alcohol, feels depressed, or has HIV risk factors. She does not. Your assistant has recorded the patient's blood pressure (normal) and weight (10 lbs over ideal). You examine the patient's breasts and pelvis while counseling her to lose 10 lbs, wear seatbelts, take calcium, and visit a dentist regularly. As you leave the room, you tell her to come back in ...References1. U.S. Preventive Services Task Force.. Guide to Clinical Preventive Services: Report of the U.S. Preventive Services Task Force. 2nd ed. Baltimore: Williams & Wilkins; 1996. Google Scholar2. Oboler SK, Prochazka AV, Gonzales R, Xu S, Anderson RJ. Public expectations and attitudes for annual physical examinations and testing. Ann Intern Med. 2002;136:652-9. LinkGoogle Scholar3. Dobell H. Lectures on the Germs and Vestiges of Disease, and on the Prevention of the Invasion and Fatality of Disease by Periodical Examinations. London: Churchill; 1861:142-63. Google Scholar4. Han PK. Historical changes in the objectives of the periodic health examination. Ann Intern Med. 1997;127:910-7. [PMID: 9382370] LinkGoogle Scholar5. Charap MH. The periodic health examination: genesis of a myth. Ann Intern Med. 1981;95:733-5. [PMID: 7030166] LinkGoogle Scholar6. Hayward RS, Steinberg EP, Ford DE, Roizen MF, Roach KW. Preventive care guidelines: 1991. American College of Physicians. Canadian Task Force on the Periodic Health Examination. United States Preventive Services Task Force. Ann Intern Med. 1991;114:758-83. [PMID: 2012359] LinkGoogle Scholar7. Canadian Task Force on the Periodic Health Examination.. The Canadian Guide to Clinical Preventive Health Care. Ottawa: Canada Communication Group; 1994:x. Google Scholar8. . The periodic health examination: age-specific charts. U.S. Preventive Services Task Force. Am Fam Physician. 1990;41:189-204. [PMID: 2294671] MedlineGoogle Scholar9. Marton KI, Sox HC, Alexander J, Duisenberg CE. Attitudes of patients toward diagnostic tests. The case of the upper gastrointestinal series roentgenogram. Med Decis Making. 1982;2:439-48. [PMID: 7182702] CrossrefMedlineGoogle Scholar10. Sox HC, Margulies I, Sox CH. Psychologically mediated effects of diagnostic tests. Ann Intern Med. 1981;95:680-5. [PMID: 7305144] LinkGoogle Scholar11. Keating NL, Green DC, Kao AC, Gazmararian JA, Wu VY, Cleary PD. How are patients' specific ambulatory care experiences related to trust, satisfaction, and considering changing physicians? J Gen Intern Med. 2002;17:29-39. [PMID: 11903773] CrossrefMedlineGoogle Scholar12. Sox CH, Dietrich AJ, Tosteson TD, Winchell CW, Labaree CE. Periodic health examinations and the provision of cancer prevention services. Arch Fam Med. 1997;6:223-30. [PMID: 9161346] CrossrefMedlineGoogle Scholar13. Kottke TE, Solberg LI, Brekke ML, Cabrera A, Marquez MA. Delivery rates for preventive services in 44 midwestern clinics. Mayo Clin Proc. 1997;72:515-23. [PMID: 9179135] CrossrefMedlineGoogle Scholar14. Flocke SA, Stange KC, Goodwin MA. Patient and visit characteristics associated with opportunistic preventive services delivery. J Fam Pract. 1998;47:202-8. [PMID: 9752372] MedlineGoogle Scholar15. Freedman A, Pimlott N, Naglie G. Preventive care for the elderly. Do family physicians comply with recommendations of the Canadian Task Force on Preventive Health Care? Can Fam Physician. 2000;46:350-7. [PMID: 10690491] MedlineGoogle Scholar16. Stone EG, Morton SC, Hulscher ME, Maglione MA, Roth EA, Grimshaw JM, et al . Interventions that increase use of adult immunization and cancer screening services: a meta-analysis. Ann Intern Med. 2002;136:641-51. LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Current Author Address: Christine Laine, MD, MPH, American College of Physicians–American Society of Internal Medicine, 190 N. Independence Mall West, Philadelphia, PA 19106; e-mail, [email protected]org. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoInterventions That Increase Use of Adult Immunization and Cancer Screening Services Erin G. Stone , Sally C. Morton , Marlies E. Hulscher , Margaret A. Maglione , Elizabeth A. Roth , Jeremy M. Grimshaw , Brian S. Mittman , Lisa V. Rubenstein , Laurence Z. Rubenstein , and Paul G. Shekelle Public Expectations and Attitudes for Annual Physical Examinations and Testing Sylvia K. Oboler , Allan V. Prochazka , Ralph Gonzales , Stanley Xu , and Robert J. Anderson Public Expectation for Annual Physical Examinations Caroline Poplin Public Expectation for Annual Physical Examinations Kei Mukohara Public Expectation for Annual Physical Examinations Sylvia K. Oboler , Allan V. Prochazka , and Robert J. Anderson Annual Physical Examination: Necessary or Needless? Daniel Reinharth Metrics Cited byUse of Tactile Contact Accompanying Health Promotion Messages During Routine Health & Physical Examinations: A Technique for Improving CompliancePelvic Examinations in the Adolescent and Young Adult Population: A Commentary on Why and WhenFacing epistemic and complex uncertainty in serious illness: The role of mindfulness and shared mindThe physical examination: a survey of patient preferences and expectations during primary care visitsAssociation Of Medicare’s Annual Wellness Visit With Cancer Screening, Referrals, Utilization, And SpendingEffect of periodic health exam on provider management of preventive servicesSurvey data on Vietnamese propensity to attend periodic general health examinationsUnderstanding type 2 diabetes mellitus screening practices among primary care physicians: a qualitative chart-stimulated recall studyRethinking the Well Woman Visit: A Scoping Review to Identify Eight Priority Areas for Well Woman Care in the Era of the Affordable Care ActPrevention and Control of DiseaseLow rate of non-attenders to primary care providers in Israel - a retrospective longitudinal studyA Visit to the Physician: Diagnoses and Enabling TechnologiesNativity and Occupational Class Disparities in Uninsurance and Routine Preventive Care Use Among Asian AmericansPrevención cuaternaria en ancianosOpen and hidden agendas of "asymptomatic" patients who request check-up examsActitud y comportamiento de la mujer frente a la prevención de la enfermedad cardiovascular“Macho Men” and Preventive Health CarePhysical examination and clinical investigationImpact of periodic health examination on surgical treatment for uterine fibroids in Beijing: a case-control studyComprehensive Outpatient Health AssessmentDo adults who believe in periodic health examinations receive more clinical preventive services?The Annual Physical Examination: Important or Time to Abandon?Commentary: Comprehensive health assessments for adults with intellectual disabilitiesMalicia sanitaria y prevención cuaternariaImproving preventive service delivery at adult complete health check-ups: the Preventive health Evidence-based Recommendation Form (PERFORM) cluster randomized controlled trialEstudio descriptivo sobre patrones de exploración física de una muestra de médicos españolesResults of a randomized controlled trial to increase colorectal cancer screening in a managed care health planPersonal view: cost and benefit of medical rituals in gastroenterologyBeyond the Pap: Assessing Patients' Priorities for the Annual ExaminationPrimary care provider perceptions of barriers to and facilitators of colorectal cancer screening in a managed care settingCancer screening and the periodic health examinationAnnual Physical Examination: Necessary or Needless?Daniel Reinharth, MDPublic Expectation for Annual Physical ExaminationsCaroline Poplin, MD, JDPublic Expectation for Annual Physical ExaminationsKei Mukohara, MDPublic Expectation for Annual Physical ExaminationsSylvia K. Oboler, MD, Allan V. Prochazka, MD, and Robert J. Anderson, MDThe Value of the Periodic Executive Health Examination: Experience at Bank One and Summary of the Literature 7 May 2002Volume 136, Issue 9Page: 701-703KeywordsBloodCancer preventionCancer screeningHealth promotionHeartLungsPreventive medicineResearch laboratoriesScreening guidelinesThorax ePublished: 7 May 2002 Issue Published: 7 May 2002 Copyright & PermissionsCopyright © 2002 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...