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Medicine and Public Policy |

Unanswered Questions about the Periodic Health Examination

WALTER O. SPITZER, M.D., M.P.H.; and BRUCE P. BROWN, M.D.
[+] Article and Author Information

Grant support: National Health grant 215-6204, Health and Welfare, Canada.

Presented in abbreviated form at the Symposium on the Periodic Health Examination sponsored by the American Federation for Clinical Research, Atlantic City, New Jersey, 3 May 1975.

▸Requests for reprints should be addressed to Walter O. Spitzer, M.D., Department of Clinical Epidemiology and Biostatistics, McMaster University, 1200 Main Street West, Hamilton, ON L8S 4J9, Canada.


Hamilton, Ontario, Canada


Ann Intern Med. 1975;83(2):257-263. doi:10.7326/0003-4819-83-2-257
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The periodic health examination in its application as a screening procedure in asymptomatic, ostensibly healthy persons is explored with a focus on the following issues: (a) the impact on health, (b) the content of a beneficial health examination, and (c) the effect of the examination on the physician-patient relation. The application discussed is distinct from use of the examination as a tool for diagnosis, prognosis, or therapeutic planning for patients with a specific illness. The discussion also shows a relatively recent change in the goal for the clinical assessment. There has been a shift in emphasis from establishing a diagnosis as the main outcome event of the periodic "checkup" to the identification of an intervention of value to the patient. Evidence from various studies that throw some light on related questions is considered. Special ethical issues surrounding the unsolicited medical assessment are identified. Finally, some ground rules for decisions about the periodic health examination are proposed.

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