02-09-2017, 12:53 PM
A general medical examination is a common form of preventive medicine that includes visits to a general practitioner by well-feeling adults on a regular basis. This is usually annual or less frequently. It is known under several nonspecific names, such as periodic health assessment, annual physical examination, general medical examination, general health checkup, preventive health examination, medical checkup, or simply a medical checkup.
In the United Kingdom, the review remains unpopular with the general population. Usually, the term does not include visits for the purpose of newborn checkups, Pap smears for cervical cancer, or regular visits for people with certain chronic medical conditions (eg, diabetes). The general medical examination usually involves a medical history, a physical examination (brief or complete) and, sometimes, laboratory tests. Some more advanced tests include ultrasound and mammography.
Although annual medical examinations are a routine practice in several countries, scientific evidence in the majority of the population supports them poorly. A Cochrane review of 2012 did not find any benefit regarding the risk of death or poor outcomes related to the disease in those who received them. People who undergo annual medical examinations however are more likely to be diagnosed with medical problems.
Some notable health organizations recommend against annual examinations. The American Cancer Society recommends a cancer-related health checkup annually in men and women over the age of 40 and every three years for those over 20 years.
A systematic review of the studies up to September 2006 concluded that screening does not result in better performance of some other screening interventions (such as Pap tests, cholesterol screening, and fecal occult blood tests) and less patient concern. The evidence supports several of these individual screening interventions. The effects of annual checks on overhead costs, patient disability and mortality, disease detection and intermediate endpoints such as blood pressure or cholesterol, are inconclusive. A recent study found that the test is associated with increased involvement in cancer screening.
The lack of good evidence contrasts with population surveys that show that the general public is fond of these exams, especially when they are free. Despite the guidelines they recommend against routine annual exams, many family physicians perform them. A fee-for-service system has been suggested to promote this practice. An alternative would be to adapt the screening interval to the age, sex, medical conditions, and risk factors of each patient. This means choosing from a wide variety of tests.
Most surgeons ask patients about the latest results of the general medical examination to be able to proceed with surgery, although there are arguments for and against most of the screening interventions. Benefits include detection and subsequent prevention or early treatment of conditions such as high blood pressure, alcohol abuse, smoking, unhealthy diet, obesity and cancers. In addition, they could improve the doctor-patient relationship and decrease the patient's anxiety. More and more private insurance companies and even Medicare include annual exams on their coverage. Some employers require mandatory health checkup before hiring a candidate, although it is now well known that some of the components of the annual prophylactic visit can actually cause harm. For example, laboratory tests and tests performed on healthy patients (unlike people with known symptoms or illnesses) are statistically more likely to be "false positives", ie when the results suggest a problem that does not exists. Disadvantages cited include time and money that could be saved through selective screening (health economics argument), increased anxiety about health risks (medicalization), overdiagnosis, misdiagnosis eg, athletic heart syndrome diagnosed as hypertrophic cardiomyopathy), as a result of unnecessary tests to detect or confirm, often non-existent, medical problems or during the performance of routine procedures as a follow-up after detection.
In the United Kingdom, the review remains unpopular with the general population. Usually, the term does not include visits for the purpose of newborn checkups, Pap smears for cervical cancer, or regular visits for people with certain chronic medical conditions (eg, diabetes). The general medical examination usually involves a medical history, a physical examination (brief or complete) and, sometimes, laboratory tests. Some more advanced tests include ultrasound and mammography.
Although annual medical examinations are a routine practice in several countries, scientific evidence in the majority of the population supports them poorly. A Cochrane review of 2012 did not find any benefit regarding the risk of death or poor outcomes related to the disease in those who received them. People who undergo annual medical examinations however are more likely to be diagnosed with medical problems.
Some notable health organizations recommend against annual examinations. The American Cancer Society recommends a cancer-related health checkup annually in men and women over the age of 40 and every three years for those over 20 years.
A systematic review of the studies up to September 2006 concluded that screening does not result in better performance of some other screening interventions (such as Pap tests, cholesterol screening, and fecal occult blood tests) and less patient concern. The evidence supports several of these individual screening interventions. The effects of annual checks on overhead costs, patient disability and mortality, disease detection and intermediate endpoints such as blood pressure or cholesterol, are inconclusive. A recent study found that the test is associated with increased involvement in cancer screening.
The lack of good evidence contrasts with population surveys that show that the general public is fond of these exams, especially when they are free. Despite the guidelines they recommend against routine annual exams, many family physicians perform them. A fee-for-service system has been suggested to promote this practice. An alternative would be to adapt the screening interval to the age, sex, medical conditions, and risk factors of each patient. This means choosing from a wide variety of tests.
Most surgeons ask patients about the latest results of the general medical examination to be able to proceed with surgery, although there are arguments for and against most of the screening interventions. Benefits include detection and subsequent prevention or early treatment of conditions such as high blood pressure, alcohol abuse, smoking, unhealthy diet, obesity and cancers. In addition, they could improve the doctor-patient relationship and decrease the patient's anxiety. More and more private insurance companies and even Medicare include annual exams on their coverage. Some employers require mandatory health checkup before hiring a candidate, although it is now well known that some of the components of the annual prophylactic visit can actually cause harm. For example, laboratory tests and tests performed on healthy patients (unlike people with known symptoms or illnesses) are statistically more likely to be "false positives", ie when the results suggest a problem that does not exists. Disadvantages cited include time and money that could be saved through selective screening (health economics argument), increased anxiety about health risks (medicalization), overdiagnosis, misdiagnosis eg, athletic heart syndrome diagnosed as hypertrophic cardiomyopathy), as a result of unnecessary tests to detect or confirm, often non-existent, medical problems or during the performance of routine procedures as a follow-up after detection.