The Billions We Spend on Our Annual Check-Ups

There’s been a news story popping up regularly this year:

In January, Ezekiel J. Emanuel, an oncologist at the University of Pennsylvania wrote an op-ed in the New York Times saying that he was skipping his annual physical, which he argued as costly and ineffective:

Around 45 million Americans are likely to have a routine physical this year — just as they have for many years running. A poke here, a listen there, a few tubes of blood, maybe an X-ray, a few reassuring words about diet, exercise and not smoking from the doctor, all just to be sure everything is in good working order. Most think of it as the human equivalent of a 15,000-mile checkup and fluid change, which can uncover hidden problems and ensure longer engine life.

There is only one problem: From a health perspective, the annual physical exam is basically worthless.

Emanuel cites research showing that screening healthy people is an ineffective way to improve people’s health, and moreover, they take up doctors’ hours that could be dedicated to treating people with more pressing health concerns.

In February, the story popped up again in the Washington Post, with the writer describing how her husband, a former athlete in good shape, hadn’t seen a doctor in five years.

And now, in April, a report from NPR: “Maybe You Should Skip That Annual Physical” reads the headline.

I’ve noticed this particular story pop up again and again because back in December, before Emanuel published his Times op-ed, I went in for a check-up. To make a long story short: The doctor ran some blood tests. The blood tests came back irregular. I’ve been back to to get my arm poked and blood drawn countless more times since (as recent as a week and a half ago), and, well, I’m being referred to someone who specializes in blood disorders now. We’re hoping it’s something minor, but I’ve had that Taylor Swift song “Bad Blood” stuck in my head for months (even though it has nothing to do with actual blood).

Of course, my personal anecdata doesn’t really change the conclusions of the news stories — that annual physicals don’t do that much to help generally healthy people — but I’ve become that person for a lot of people in my life (several family members recently went to get their blood tested as well). As Emanuel writes: “Almost everyone thinks they know someone whose annual exam detected a minor symptom that led to the early diagnosis and treatment of cancer, or some similar lifesaving story.”

In any case, I guess what we can make of all this is that my experience doesn’t matter to you and Emanuel’s op-ed is a broad assessment. You know your own body. Your doctor will recommend that you do whatever you need to do when the time comes (i.e. blood tests to check cholesterol levels every four to six years). I wish you good health.

Photo: Frankie Leon

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