September 28, 2007

Let's Get Physical--Some Other Time

This is a quick slacky vacation post to throw you all off guard. Is she here? Is she gone? What's up with that? Guess we really should check in every day!

Anyway, so a new study is out questioning the medical benefits of an annual physical exam. Apparently they're not really worth the cost most of the time, especially since preventative care can be delivered during other office visits. The article noted that most people came in for other medical visits during the year anyway.

The study's author said: "Although annual exams are not recommended by any major North American clinical organization, our health system is clearly devoting a great deal of time, money and resources to them."

On the other hand, they said "preventive physicals and preventive gynecological exams were the most common venue for evidence-based preventive services like mammograms and Pap smears." What the heck does that mean? So should Crabby keep seeing her very nice gynecologist every year but stop feeling guilt when she 'forgets' yet again to schedule a physical? Crabby should probably dig around for the real study rather than the summary, but this is not a real post and she's not really here so she'll leave that for more diligent health news reporters to do.

According to their numbers, 21% of Americans got a physical, while about while about 18% of women went in for a preventive gynecological exam. This apparently cost bazillions of dollars that could have been better spent on other things. The average physical lasted 23 minutes and cost $116, including related laboratory and radiology services.

Interestingly enough, a person who lived in the Northeast was 60 percent more likely to get a physical than someone who lived in the West.

Crabby thinks common sense should prevail here--a young healthy person without much worrisome family history should probably not be hauled in every year for a morning spent reading ancient magazines, an chance to model an ugly paper gown, and the opportunity to pee in a cup (or all over her hand, if she's got bad aim. TMI? Sorry). On the other hand, it's probably not a good idea to play hooky from the Doctor's office indefinitely, especially if you're getting on in years, have no idea what your cholesterol or other important numbers look like, and have family members who are in the habit of dropping dead at young ages.

Crabby always thinks of herself as the first sort of person, the healthy youngster, who doesn't really need to bother coming in unless she's sick (which she pretty much never is). But actually, she's getting to be more like person two, the middle-aged Doctor Avoider who should Get her Butt in for a Checkup Someday. So a physical is now at least on her to-do list.

So do you folks get physicals every year? Ever? Do you go to your ob/gyn if you have that particular set of equipment? Any thoughts or opinions on medical care generally or anything else on your minds?

(And Crabby hasn't forgotten about Crab Facts. Stay tuned... for those who actually care, some may be coming along any day now!)


  1. I read that article earlier this week and was thinking about doing a post on the same thing. Darn, now someone's going to say that I've stooped so low as to steal from a crab! Oh boy...

    Seriously, it's an interesting topic. I think if you don't have any serious issues, it's likely that during young adulthood you don't need a physical. However, I think this does change as we grow older because many of the health issues that can affect us are not always obvious and can be discovered earlier through proper questioning by the healthcare prof doing the exam.

    For example, the issue of type 2 diabetes - signs and symptoms may be picked up in the course of a good physical and then followed by blood tests. Hyperension is a silent killer, that too may be picked up by accident.

    Annual physicals also allow people (hopefully!) to ask about things that they may be wondering about.

    So, I'm not for abandoning the annual physical; I do think it has its place.

  2. My doc is big on annual physicals and I'm big on weaseling my way out of them.

    I have no worrisome family history, I've never had a weight problem, and a twelve mile run is no big deal.

    Unless I have worrisome symptoms, I see no need for an annual physical. Every other year or every third year, sure. But annually? It's a waste of everyone's time. No test has has ever turned up even the smallest item of concern. So until there's something that requires annual evaluation, I'll keep doing what I can to get out of the once-a-year physical.

  3. I want Crab Facts! I want Crab Facts now! But I will be patient. All good things come to she who stuffs a sock in it and waits.

    I go for a physical every other year. I used to go for a pap test every year, then reached the age and no. of good tests that allowed me to go on alternate years. I figure if it's good enough for the pap, then it's good enough for everything else.

    If I absolutely need to go to a doctor, then I will, but I avoid it as much as possible simply because you pretty much have to be on your deathbed here to get any attention.
    "Hmm, it's not a complete decapitation, so let's just monitor it."

  4. I've been a medical mess for a while now, so the doc & I are no strangers. Fortunately my hypertension & diabetes (T2) are under fantastic control, especially since my weight loss. But I'm also quickly approaching the age where I'll need to have the recommended annual colon cancer screenings and such, so I'll be contributing to my doc's retirement fund for the foreseeable future.

  5. I do get a physical every couple of years, but tend to wait until I feel that there is something wrong with me. Overall, I am (fortunately) pretty healthy and do hope it stays that way!
    I am also very thankful for health insurance...

  6. Errr.. on my desk is a requisition for blood tests, an ultrasound - both of which I'm supposed to do twice a year as a (questionable) screening for ovarian cancer (family history), and an annual mammogram. I'm supposed to get these things taken care of, and make an appointment for a physical shortly afterward. I'll do it soon.. probably. The requisition is dated April 23/07. I think I should go back and re-read Lily's post from yesterday.

  7. I haven't been to the Doctor in for physical since I was in high school. But I have gone to my obgyn fairly regularily.

    That said, I always worry about my husband, he has lots of quirky little health issues. Nothing serious really but I'm always wanting him to go in for a routine checkup. I'm scared his acid reflux has finally completely eaten away his esophogus and he just doesn't know it.

    Then again, when you have crappy insurance it's not exactly motivating to want to go spend a bunch of money to have a doctor tell you you're fine.

  8. I read that article too, and found it interesting. But, personally, my doctor is also my OB/GYN, and so my annual physical is pretty much my annual pelvic with a few other stages to make sure everything's in working order (although, given my lifestyle, my doctor's at the point where he just walks in and says, "so...still healthy as a horse?" He always ensures I'm back every year though by giving me only a year's worth of birth control, so I need to head back for a new prescription.

    For me, a full on annual physical doesn't make a lot of sense. I'm healthy, and don't have much of a family history of anything, and I can see how it could be that way for a lot of people. There's definitely an attractive quality to deciding for yourself. Now, I suppose that would have to be within reason, and might rely on the individual to decide when to go, but as long as people are reasonably self-aware and not willing to hold off too long if something really is wrong, then I don't see a problem in getting rid of annual physicals, especially in cases where they're not so necessary.

  9. my first physical in like 10 years is what spearheaded this whole health transformation.

    I'm glad I did it. A had a whole whack of stuff wrong with me that i couldn't see beyond the weight that I've now corrected and will now make the physical a part of my yearly preventative maintenance.

    I'm lucky too that I got rid of a crappy doc and found an AWESOME one who listens to me, sends me to specialists "just in case" because of medications I'm on and has offered me other tips with my asthma medication that no other doc has ever taken the time to discuss with me.

  10. As pilot, I have a biannual flight physical as a requirement for maintaining my currency.
    As for Physicals, I think with the over dependency on laboratory tests and technology, the skill of physical diagnosis is a fading art :-(

  11. Crabby,

    I think that annual physicals fall under the "can't hurt, might help " category.


  12. Wow! Interesting.
    Like some of the others, I go to my ob/gyn every year since she will only prescribe birth control for one year, and she does her fun ob/gym exam, and I see the thyroid doc once a year to get that checked (underactive) but I don't think I've had a full physical since high school (I'm 45). I feel great, hardly ever get sick, so it doesn't seem worth the bother.
    Interesting post!

  13. "Any day now, Crab facts will come along..." Sheesh, now I've got that damn song stuck in my head!
    Hope you're enjoying your family visit, doing all those tourist-y things in the big city. We're all a teensy bit jealous, but the baked nacho chips and home-made salsa are a small consolation...too bad you're missing out! (Hmmm, fabulous and exciting adventures, or chips and salsa - tough choice!)

    I agree with Terrie about the physicals - to a degree. If the doc finds you to be in good health, and you are feeling well, I don't think you need to go on a yearly basis. Every couple of years should suffice. Unless you are, for example, a pilot. Or there is a family history of something deadly, as is the case in my family. Already have my examination scheduled next month for colon cancer.
    Hilary, stop procrastinating!! Make the damned appointment. (that was me being stern, did it work?)

  14. I go every year (mostly because I get a new doctor seems like every year and they want to get to know me I guess!) I'm glad I do because I always have some little question that didn't warrant it's own visit but I can get it in with this. Plus that's how I found out about high cholesterol which I would have never expected at only 25! It seems like a trend is husbands not going (ever) and seems like they should. Wonder why that is?

  15. ever since i can remember, i get checked-out once a year by my primary care physician, my ob/gyn, and my dermatologist... i also get my teeth cleaned twice a year but doesn't everyone? :o)

  16. Baglady,

    Yes it worked! I'll make the appointment.. "any day now"... ;)

  17. yes, get the physical each year. but don't assume that just because a pap comes back neg that there's nothing wrong with your reproductive organs! it doesn't catch ovarian cancer or other things like endometriosis.

  18. i come from the school of "if it aint broke, dont fix it"... I havent had a physical for plum near ten years....

    gp in montana who'll have a healthy ride tomorrow maybe in snow !

  19. I used to be the "I'm young, nothing can happen to me" girl, but now I'm getting a physical once a year all the same. The gyn one is more out of habit, I admit; I would do it for breasts exam, because I'm quite positive that with the amount of boobage I have, I would be totally unable to find a cyst or something all by myself. And my gyn usually does a pap smear as well and asks for a blood test along the way, so I get everything at the same time. (I must nevertheless admit that I have a rather panicky fear of cancer, and I don't want to be caught unaware by this. After all, the illnesses I feel/see by myself are the less invasive ones, such as colds; and too often the symptoms of many more dangerous ones are caught when it's already too late.)

    Same for the dentist. I was never taught to properly care about teeth, the result of which was me going every 4-5 years only, and it's only recently that I've learnt that having a cavity doesn't mean having to go three times in a row with heavy anaesthesia to get the damage repaired... not if I get a regular check-up, that is. *sigh*

    I have my eyes checked less regularly, though--every 3 years or so. My near-sightedness developed quite late, and it hasn't been budging since the age of 22-23, so I tend to slack off on this. But I ask my regular doc to have my thyroid checked regularly as well, since my mother has Hashimoto and it could be hereditary. I am NOT letting myself be sick and gain weight and crap for two years, like it happened with her, just because I don't want to go to the doctor.

    No, no, I'm not hypocondriac. Honest. ;)

  20. Nope. As scared as I am of getting cancer I don't go! I don't want to know. (la la la I can't heeeeear you!) That said, I know the best way to prevent most disease is early detection. Oh well. I hope I go quick!

  21. This is off-topic, but I was just in a pharmacy (buying drugs for my poor dog) and I saw a box labeled "The Cookie Diet, as followed by the Hollywood Stars!" Gosh. For only $19.99 I could have in my hands 12 meal-replacement cookies that were just gosh darn going to make me look like a celebrity!

  22. Hi All,

    Great comments as usual, thanks so much for coming by and brightening up the place!

    The whole Crab Family is having a great time, as we are sightseeing and eating our way through a good part of Washington D.C.

    Our excitement this morning came when we picked up a Churchgoing Crab Relation from Mass--which turned out to be the Mass at which the Supreme Court members get blessed or whatever! Anyway, leaving the church we saw several Supremes in person. (Alas, not my favorites--I was only able to recognize Thomas, Scalia and Roberts) but it was still fairly exciting for a Crab who doesn't get out much.

    So thanks again for your patience! There is plenty more to come, though anything remotely Informative will be served up from our great line-up of guest posters.

    Thanks again and see you all soon!

  23. Karen takes me every freaking year for my annual checkup.

    Like clockwork

    I hate it.

    The alleged terrorists in Guantanimo (sp???) are treated with more civility than I am with the bright lights shining in my eyes and the cold tube stuck in unmentionable places.

    Last year I attacked my vet. Karen chewed me out afterwards. But I'm sorry, I just don't think I should have to put up with such behavior. We'll see how it goes this year . . .

    -- P

  24. You know, cars have officially gone from the 'ole 3000 miles before maintenance/oil change to 7500 miles. We keep getting better and living longer - maybe we can stretch it out a little longer too. I mean what is so special about 12 months versus 13 1/2 months or 17 3/4 months...

  25. All of my friends (now that we're MEDIUM...that sounds so much younger than middle aged)are always getting on to me for not getting checkups and physicals and poked and squished regularly. I know that all kinds of things can happen (and do often) to a person that can be life threatening if not diagnosed and treated early enough, but I have found that every time I've gone to the doctor (other than delivering my child or having a tooth pulled) it has been a complete waste of time and money. I haven't ever gone until someone pressured me into going and I was charged a shitload of money to be told "yup, you're sick...go to bed" or "yup, it's sprained...don't use it". Now I realize bigger, more life threatening situations arise, but a friend of mine went through a THOROUGH exam including MRI and CAT scans, and almost died two weeks later from diverticulitus. Go figure. So much for the need to make sure everything's aging well, huh?


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