Time for a Checkup?

WHAT ABOUT MY ROUTINE PHYSICAL?

''Doc! I just turned (20,30,40,50,60,70,80) and I need a routine physical.''

We can do that. I learned how to do ''complete physicals'' in medical school. The only question is SHOULD we do that?

For decades the Routine Physical Exam (now more often referred to as the Periodic Health Evaluation) was sort of the Holy Grail of Medicine. The assumption was that routine evaluation of a patient would detect problems early when they could be fixed. This intuitive belief was touted in spite of a total lack of any data to support it. Good old Kaiser was one of the first to create a body of evidence-based (show me the numbers) data on routine exams and testing. In a huge study over several decades a body of data was collected on two groups of people; those who wanted and got a routine exam and lab tests every 1 - 2 years and those who said ''No thanks - see you when I get sick.''

It came as somewhat of a surprise when the data was looked at and we found that people who got regular exams did not live longer or better than those who did not. We did find more cases of colon cancer, breast cancer, cervical cancer and prostate cancer - but again this did not translate into better survival.

This has been looked at by other organizations such as the United States Public Health Service, the American College of Physicians, the American Cancer Society and the American Academy of Family Practice. The recommendations of these groups are very similar. Our suggestions on routine health care and testing are summarized in your ''Healthwise Handbook'' which you should have received when you enrolled in our health plan in the chapter ''Prevention and Early Detection''. These recommendations also are posted on a chart in most of the exam rooms and offices of our Medical Center.

Mostly it boils down to common sense: Exercise, don't smoke, eat right to maintain a healthy body weight, wear your seat belts, don't drink and drive (in fact don't drink much at all), lock up the poisons and guns at home so your kids can't get at them, don't get sunburned. It turns out that most ''routine'' physical exam stuff and blood testing is NOT recommended. If you are the kind of analytical person who wants to know what the evidence is behind the recommendations visit the USPHS site below.

U.S. Preventive Services Task Force

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