Is it Worth Getting Annual Health Check-Ups?

Michael Greger M.D. FACLM · October 9, 2017 · Volume 38

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What are the risks and benefits of getting an annual check-up from your doctor?

Discuss

Transcript

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

“Physicians and patients have come to expect” the annual check-up as a routine part of care. “However, considerable research has not demonstrated [it has any] substantial benefit[s].” And so, “[a] revolt is brewing against the tradition of periodic” check-ups. “Even the Society for General Internal Medicine [has] advised primary care physicians to avoid [such] “routine general health checks for asymptomatic adults.’”

Check-ups seem to make sense, but “historically, medical practice has included [all sorts of things that seemed to make sense], such as hormone replacement therapy” for menopause—until it was put to the test, and found to increase the risk of breast cancer, blood clots, heart disease, and stroke. Or, like when doctors killed babies by making the so-called “common sense” recommendation that infants sleep on their tummies, whereas we all know now “Face Up to Wake Up.”

“We should always demand evidence.”

“We check our cars regularly, [though], so, why shouldn’t we also check our bodies…”? Well, unlike cars, our bodies have “self healing properties.” To see if the benefits outweigh the harms, researchers decided to put it to the test.

So: “What are the benefits and harms of general health checks for adult populations?” The bottom line is that check-ups “were not associated with lower rates of…mortality,” meaning not associated with living longer, or a lower risk of dying from heart disease, stroke, or cancer. So, general check-ups may not reduce disease rates or death rates, but they “do increase the number of new diagnoses.” And, the “[h]armful effects of [the] tests and subsequent treatment[s] could have balanced out [any benefits].”

“Possible harms from [check-ups include] overdiagnosis, overtreatment, distress or injury from invasive follow-up tests, distress due to false positive test results, false reassurance due to false negative test results, possible continuation of adverse health behaviours due to negative test results, adverse psychosocial effects due to labelling, and difficulties with getting insurance” now that you have a pre-existing condition—not to mention all the associated costs.

For example, diabetes. Wouldn’t it be great if we picked up a case of diabetes earlier? Perhaps not, if they were given the #1 diabetes drug at the time, Avandia—which was pulled off the market because, instead of helping people, it appeared to be killing people. “Adverse drug events are now [one of our] leading causes of death.” When it comes to lifestyle diseases, like type 2 diabetes, maybe we should instead focus on creating healthier food environments—like my new favorite organization, Balanced—to help prevent the diabetes epidemic in the first place.

How many times have you tried to inform someone about healthy eating, about evidence-based nutrition, only to have them say, “No, I don’t have to worry. My doctor says I’m okay. I just had a check-up; everything’s normal.” As if having a normal cholesterol is okay in a society where it’s normal to drop dead of a heart attack—the #1 killer of men and women. I mean, if you went to see a lifestyle medicine doctor who spent the check-up giving you the tools to prevent 80% of chronic disease, that’s one thing. But given the way medicine is currently practiced, it’s no wonder, perhaps, why “[t]he history of routine check[-up]s has been one of glorious failure, but generations of well meaning clinicians [just don’t want] to believe it….Policy should be based on evidence,” though.

“Poor diet” is on par with cigarette smoking as the most common actual cause of death; yet, the medical profession is “inadequately” trained in nutrition. Worse, nutrition education [in medical school] appears to be in decline,” if you can believe it. A “shrinking” of nutrition education among health professionals. So, the advice you get in your annual check-up may just be from whatever last tabloid your doctor skimmed in the check-out line.

“[S]creening [opportunities] should not be regarded as a form of ‘health education,'” one medical journal editorial read. “People who are obese know very well that they are, and if we have no means of helping them…, then we should [just] shut up.” Well, if you really have nothing to say that will help them, maybe you should shut up—especially doctors who say they “have no idea what constitutes a ‘healthy’ diet,” though veggies and nuts are a good start.

Please consider volunteering to help out on the site.

Sources

Acknowledgements

Icons created by Edwin Prayogi, Kate Maldjian, Artem Kovyazin, and Mello from The Noun Project.

Image credit: geralt. Image has been modified.

Motion graphics by Avocado Video.

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

“Physicians and patients have come to expect” the annual check-up as a routine part of care. “However, considerable research has not demonstrated [it has any] substantial benefit[s].” And so, “[a] revolt is brewing against the tradition of periodic” check-ups. “Even the Society for General Internal Medicine [has] advised primary care physicians to avoid [such] “routine general health checks for asymptomatic adults.’”

Check-ups seem to make sense, but “historically, medical practice has included [all sorts of things that seemed to make sense], such as hormone replacement therapy” for menopause—until it was put to the test, and found to increase the risk of breast cancer, blood clots, heart disease, and stroke. Or, like when doctors killed babies by making the so-called “common sense” recommendation that infants sleep on their tummies, whereas we all know now “Face Up to Wake Up.”

“We should always demand evidence.”

“We check our cars regularly, [though], so, why shouldn’t we also check our bodies…”? Well, unlike cars, our bodies have “self healing properties.” To see if the benefits outweigh the harms, researchers decided to put it to the test.

So: “What are the benefits and harms of general health checks for adult populations?” The bottom line is that check-ups “were not associated with lower rates of…mortality,” meaning not associated with living longer, or a lower risk of dying from heart disease, stroke, or cancer. So, general check-ups may not reduce disease rates or death rates, but they “do increase the number of new diagnoses.” And, the “[h]armful effects of [the] tests and subsequent treatment[s] could have balanced out [any benefits].”

“Possible harms from [check-ups include] overdiagnosis, overtreatment, distress or injury from invasive follow-up tests, distress due to false positive test results, false reassurance due to false negative test results, possible continuation of adverse health behaviours due to negative test results, adverse psychosocial effects due to labelling, and difficulties with getting insurance” now that you have a pre-existing condition—not to mention all the associated costs.

For example, diabetes. Wouldn’t it be great if we picked up a case of diabetes earlier? Perhaps not, if they were given the #1 diabetes drug at the time, Avandia—which was pulled off the market because, instead of helping people, it appeared to be killing people. “Adverse drug events are now [one of our] leading causes of death.” When it comes to lifestyle diseases, like type 2 diabetes, maybe we should instead focus on creating healthier food environments—like my new favorite organization, Balanced—to help prevent the diabetes epidemic in the first place.

How many times have you tried to inform someone about healthy eating, about evidence-based nutrition, only to have them say, “No, I don’t have to worry. My doctor says I’m okay. I just had a check-up; everything’s normal.” As if having a normal cholesterol is okay in a society where it’s normal to drop dead of a heart attack—the #1 killer of men and women. I mean, if you went to see a lifestyle medicine doctor who spent the check-up giving you the tools to prevent 80% of chronic disease, that’s one thing. But given the way medicine is currently practiced, it’s no wonder, perhaps, why “[t]he history of routine check[-up]s has been one of glorious failure, but generations of well meaning clinicians [just don’t want] to believe it….Policy should be based on evidence,” though.

“Poor diet” is on par with cigarette smoking as the most common actual cause of death; yet, the medical profession is “inadequately” trained in nutrition. Worse, nutrition education [in medical school] appears to be in decline,” if you can believe it. A “shrinking” of nutrition education among health professionals. So, the advice you get in your annual check-up may just be from whatever last tabloid your doctor skimmed in the check-out line.

“[S]creening [opportunities] should not be regarded as a form of ‘health education,'” one medical journal editorial read. “People who are obese know very well that they are, and if we have no means of helping them…, then we should [just] shut up.” Well, if you really have nothing to say that will help them, maybe you should shut up—especially doctors who say they “have no idea what constitutes a ‘healthy’ diet,” though veggies and nuts are a good start.

Please consider volunteering to help out on the site.

Icons created by Edwin Prayogi, Kate Maldjian, Artem Kovyazin, and Mello from The Noun Project.

Image credit: geralt. Image has been modified.

Motion graphics by Avocado Video.

Doctor's Note

Won’t a check-up allow your physician to do a comprehensive physical exam and routine blood testing? I discuss that, as well as the pros and cons, in my next video: Is It Worth Getting an Annual Physical Exam?.

Did I say lifestyle medicine? Yes! Learn more about this exciting growing field in Lifestyle Medicine: Treating the Causes of Disease and Convincing Doctors to Embrace Lifestyle Medicine.

Still don’t understand how there can be risks? See Why Prevention Is Worth a Ton of Cure. Unfortunately, physicians and patients alike wildly overestimate the benefits of pills and procedures. See, for example, The Actual Benefit of Diet vs. Drugs.

The fact is Physicians May Be Missing Their Most Important Tool.

And what about mammograms? See my video series:

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