Debating Whether Checkups Are Time Wasted or Time Misused

Nearly a century has passed since the American Medical Association endorsed “periodic medical examinations of apparently healthy persons.”

These examinations were “designed to detect the early evidence of disorder before discomfort, inconvenience, interference with work, or anxiety [had] driven [apparently healthy people] to seek medical advice for the treatment of established disease,” Haven Emerson, MD, chair of the AMA’s Committee on Health and Public Instruction, wrote in JAMA in 1922.

Despite Cigna’s recent television commercials, in which TV physicians exhorted viewers to get an annual examination, real physicians and other interested parties have debated the value of checkups for decades.

Randomized trials comparing outcomes among participants receiving periodic health checks or no health checks have found the examinations did not reduce morbidity or mortality overall or from cardiovascular disease or cancer. Based on these studies, the Society of General Internal Medicine, as part of the “Choosing Wisely” initiative, concluded that “the evidence base is definitely insufficient to support the routine use of annual general health checks for asymptomatic adults without a specific concern, chronic condition, or evidence-based prevention strategy.”…

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