Figures give that around 63 million U.S. adults visit a doctor yearly for a routine medical or gynecological check-up. The total costs from these come up to $7.8 billion, according to the study findings. Yet, almost all or more than 80 percent of preventive care provided by doctors does not take place during this annual check-up, the findings also show. In addition, more than $350 million worth of potentially unnecessary medical tests are performed, say the researchers led by Dr. Ateev Mehrotra of the University of Pittsburgh School of Medicine and the RAND Corp.
"We need to question encouraging everybody to come in for an annual physical", opines Mehrotra.
"There's a lot of money, a lot of visits, a lot of adults going to see their doctor for annual physical exams with a real unclear benefit. It's the No. 1 reason adults see their doctor, and yet we don't know whether it's helpful or not," he adds.
The study, which was published in the Archives of Internal Medicine, also found that these check-ups account for one in 12 adult outpatient visits to the doctor's office. On average, they last 23 minutes and cost $116, including laboratory and radiology services.
In addition, the study also documented differences across the country in routine annual physicals. People in the Northeast are far more likely to get them than those in the West. The kind of care and testing provided by doctors also differs by locality.
This is not all. The study found that many patients were routinely given laboratory tests such as complete blood cell counts or urinalyses of uncertain medical value in the absence of a specific reason.
According to Mehrotra, no major North American clinical organization advises people to get an annual medical check-up, yet most adults think they should get one and most doctors recommend them.
"I'm not saying that preventive care itself is not helpful. It is clearly helpful -- mammograms, pap smears, cholesterol screening, colon cancer screening, prostate cancer screening. And patients should get those. But does it need to happen at this special visit? Or can we get it some other way?" he questions?
The institution of the annual medical check-up, intended to detect or prevent unseen health problems dates back about a century in the United States, Mehrotra says. In spite of this, large studies in the 1960s and 1970s have failed to show that these check-ups provide a significant medical benefit to the patient.
As part of their study, the researchers examined government survey data from 2002 to 2004, and questioned doctors nationwide about what they did during the check-ups.
Only 20 percent of eight preventive services tracked by the researchers were performed at these check-ups as opposed to during other types of visits to doctors, the study showed. Also, most patients visited the doctor for some other reason during a given year.
"Is a physical harmful at all? To the patient, there's likely little harm. The potential downsides of a physical are the money and people's time, as well eating up a doctor's time that might be better used elsewhere", opines Mehrotra.