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Editorials |7 May 2002

The Annual Physical Examination: Needless Ritual or Necessary Routine?

Christine Laine, MD, MPH, Senior Deputy Editor

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Author, Article, and Disclosure Information

  • Current Author Address: Christine Laine, MD, MPH, American College of Physicians–American Society of Internal Medicine, 190 N. Independence Mall West, Philadelphia, PA 19106; e-mail, claine@acponline.org.

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Imagine that a 45-year-old married, premenopausal woman with no chronic or acute medical problems, unremarkable family history, normal cholesterol level 2 years ago, and no tobacco use presents to you requesting an “annual physical.” You ask whether she drinks alcohol, feels depressed, or has HIV risk factors. She does not. Your assistant has recorded the patient's blood pressure (normal) and weight (10 lbs over ideal). You examine the patient's breasts and pelvis while counseling her to lose 10 lbs, wear seatbelts, take calcium, and visit a dentist regularly. As you leave the room, you tell her to come back in 3 years unless the Papanicolaou smear is abnormal or she experiences new symptoms of concern.
Would this patient feel well cared for? Probably not. More likely, she would feel like a virtual stranger had just pried into her private life and into her body. Yet, you would have completed a periodic health examination that fully adheres to preventive health guidelines (1). Unfortunately, this patient has not read the guidelines. She expected you to listen to her heart and lungs, but you did not. She expected “blood work,” but you did none. She expects to see you yearly, but you told her not to come back for 3 years.
In this issue, Oboler and colleagues (2) present evidence showing that many Americans are unfamiliar with prevention guidelines. Of 1203 surveyed adults, 66% believed in the necessity of annual physical examination. Furthermore, when Oboler and colleagues compared the desired services with...
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Laine C. The Annual Physical Examination: Needless Ritual or Necessary Routine?. Ann Intern Med. 2002;136:701–703. doi: 10.7326/0003-4819-136-9-200205070-00013

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Published: Ann Intern Med. 2002;136(9):701-703.

DOI: 10.7326/0003-4819-136-9-200205070-00013

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2002 American College of Physicians
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