Pros and cons of annual physical discussed

(HealthDay)—The pros and cons of the annual physical are discussed in two perspective pieces published online Oct. 14 in the New England Journal of Medicine.

Allan H. Goroll, M.D., from Massachusetts General Hospital in Boston, discussed the appeal of the annual physical, which is supported by patients and physicians despite a lack of hard evidence of its benefits. The author suggests that the appeal lies in people's desire to maintain a close and trusting relationship with their personal physician. Benefits of a therapeutic relationship include enhancements in functional status, patient satisfaction, and adherence to medication regimens. The annual physical should be improved, perhaps by transitioning to a team effort, and could function as an annual health review, the author writes.

Ateev Mehrotra, M.D., M.P.H., from Harvard Medical School in Boston, and Allan Prochazka, M.D., from the University of Colorado Health Sciences Center in Denver, discussed the case for elimination of the annual physical. They note that two systematic reviews concluded that annual physicals do not reduce morbidity or mortality, although they may reduce patient worry and increase preventive care use. Evidence has suggested potential harms of annual visits. The authors recommended a three-step approach that includes creating a new type of visit whose role is to establish relationships, ensuring that patients' preventive care is up to date, and eliminating reimbursement for annual physicals.

"We believe it's time to act on this evidence and stop wasting precious primary care time by having a third of the adult population come in for such visits," Mehrotra and Prochazka write.