Physicians rethink the annual visit

Some physicians are reconsidering the value of the annual physical, pointing to long waits for primary care visits and studies that indicate yearly physical exams don't have a clear connection to improved health among asymptomatic patients, The Wall Street Journal reported Feb. 19. 

While the traditional annual exam typically involves a blood pressure check, blood tests, and a recording of patients' height and weight, a growing number of physicians are considering whether young, healthy patients really need the routine checkups, given the prevalence of chronic diseases such as obesity have continued to rise and mixed findings on the exam's value for otherwise healthy patients. 

Many physicians still recommend a yearly exam for all patients, but more are changing the way they approach the visits, focusing more on patients' personal health goals and lifestyle habits such as sleep, diet and exercise. 

"There are parts of what we do in a yearly exam that are valuable," Yul Ejnes, MD, a primary care physician who sits on the American Board of Internal Medicine, told the Journal. "It's just that the delivery method that's been used for decades may not be as effective as we think." 

There are various ways companies and physicians are redesigning the yearly exam, depending on a person's age and health history. One Medical, for example, has patients fill out a survey before their visit with questions on lifestyle habits and family health history. In some cases, physicians may skip certain aspects of the physical exam, such as looking in a patient's ears, leaving more room for patients' specific questions and concerns. 

"I could take a slew of vital signs and check reflexes and listen to your heart and you could leave that exam without any of the questions that you're hoping to get answered," Hemalee Patel, DO, who leads a chronic-disease management team at One Medical, told the news outlet. 

Other approaches involve pairing pre-visit screenings and blood test results with technology — like data from a person's wearables — to determine which patients have more urgent health needs and require an in-person primary care visit sooner, and when virtual care might be a better fit. 

Some physicians also say spending less time on routine wellness exams for young, healthy people could also ease the shortage of primary care physicians, according to the Journal. 

Still, supporters of the traditional yearly exam say it enables them to catch conditions they may have otherwise missed and puts patients at ease, especially as they get older. The latest recommendations from the Society of General Internal Medicine state people at risk of chronic disease, as well as those who rarely see their physician or are worried about their health, are likely to benefit from routine exams. 

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