Forget your annual physical

You probably have your annual physical because you think it might prevent you from becoming ill. I did that for a while too, then quit about 12 years ago. I like my local doc just fine, but I didn't see any value in the checkups, and we would end up arguing about my cholesterol. I’m not worried about my cholesterol, even though it’s “high” by some standards. I also don’t believe in cholesterol-lowering drugs (more about that later). So I’ve not had my cholesterol checked for 12 years. My doctor’s final words to me were, “Call me if you ever get sick.”   

To bolster my anti-annual-checkups stance, I can cite the recommendations of the “Choosing Wisely” campaign of the Society of General Internal Medicine. One of the recommendations is: “Don’t perform routine general health checks for asymptomatic adults” (people who feel fine). Regularly scheduled general health checks, according to this group of doctors, “have not shown to be effective in reducing morbidity, mortality or hospitalization, while creating a potential for harm from unnecessary testing” [italics mine]. This conclusion was the result of studies that included nine trials of 155,899 patients. So, according to this medical organization, by refusing my annual physical, I’m doing the right thing. (You can Google “Choosing Wisely” for more information.)

Annual checkups, which are promoted by physicians and requested by patients, are one of the two most common reasons people visited their health care providers in the US and Canada (2009). Dr. Gilbert Welch, author of Overdiagnosed, tells us that American medicine is “expanding relentlessly.” A major reason for this expansion is an increasing tendency to make diagnoses. In fact, Welch calls our current situation an “epidemic of diagnoses.” Conventional wisdom would have you believe that finding problems early saves lives—that you can fix small problems before they become big problems. But these “small problems” are likely to be little abnormalities that would never bother us. What’s more, getting a diagnosis of high cholesterol or hypertension, for example, turns you into a sick person. And more diagnoses leads to excessive treatment for problems that aren't bothersome at all. (“Over-diagnosis” by the way, refers to diagnosing a supposed “condition” that will never cause symptoms or death.)

Update: Right after I posted this, my son Glenn sent me an op-ed piece from The New York Times with essentially the same message. It's written by an oncologist. I recommend it.

Update II: My granddaughter Maggie sent me this piece that she heard on NPR with the same message.

Next week I'll show that all of this medical treatment is not helping our health.

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