Ask Well: Do I Need an Annual Physical?

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An annual physical, which is routine for about 45 million Americans, is not required to stay healthy, but it is a good way to build a relationship with your physician.

According to a 2012 study in BMJ Open, annual checkups don’t help people avoid death, hospitalizations, worry or future appointments. In addition, an annual physical can lead to unnecessary procedures that put a patient at risk for complications and push up medical costs.

But “if you didn’t go in for a complete physical, you’re only going to the doctor when you’re sick, and that makes absolutely no sense,” said Dr. Pieter Cohen, an internist with the Cambridge Health Alliance and an assistant professor of medicine at Harvard Medical School.

A physical is a good time for patients to check in about medications and whether their benefits still outweigh possible side effects, Dr. Cohen said. Physicals also provide doctor and patient a chance to get to know each other without the stress of a crisis, said Dr. David Himmelstein, a professor of public health at City University of New York.

“I think I take better care of people if I know who they are and have some sense of connection to them,” said Dr. Himmelstein, who sees his internist every year or so.

The main problem with physicals, Dr. Cohen said, is that they are designed for the needs of insurance companies, not patients.

“This idea of what we call the routine physical is a completely arbitrary construct based on billing,” Dr. Cohen said. For example, doctors are supposed to ask about symptoms in every organ system, even if the patient has much more limited concerns, he said.

The solution is not to throw out the annual physical, but to improve it, Dr. Himmelstein said. He suggested making more time for genuine interaction between doctor and patient, and spending less time on tests that offer little value and raise the risk of overtreatment.