Skip Your Annual Physical


I have never not had an annual checkup myself. All my physical examination were done for insurance purposes only. I found these exams to be exercises in futility. Medical checkups for specific reasons, of course, are crucially important.

In a companion article, I explain why I do not perform routine pelvic examination for my female patients. My position on annual checkups have been looked with deep suspicions by most doctors. That has not been my problem.

Annual checkups by American doctors (with disturbingly few exceptions) do not include any tests for the following (which I consider to be crucial):

1. Insulin toxicity
2. Toxic metal load
3. Environmental toxicities
4. Mold and food allergy
5. Assessment of nutrient assessment.

With background, I was pleasantly surprised to find an article titled “Skip Your Annual Physical” in The New York Times of January 8, 2015. Consider the following quotes from that article:

“From a health perspective, the annual physical exam is basically worthless. In 2012, the Cochrane Collaboration, an international group of medical researchers who systematically review the world’s biomedical research, analyzed 14 randomized controlled trials with over 182,000 people followed for a median of nine years that sought to evaluate the benefits of routine, general health checkups — that is, visits to the physician for general health and not prompted by any particular symptom or complaint.”


Majid Ali MD, $7.4 Billion for Doctors to Sell Drugs – www.AliScience.org from Majid Ali on Vimeo.


On January 18, the Times published some letters from readers which included the following (which makes some good points but still does not address the real issues I cover above:

“To the Editor” “Skip Your Annual Physical,” by Ezekiel J. Emanuel (Op-Ed, Jan. 9), has caused an uproar in my internal medicine practice. When patients call to cancel their annual physical, I must explain that while Dr. Emanuel may be correct that studies don’t show how exams reduce mortality, the annual physical is about so much more.

Nobody Should Carry Insurance Card to Doctors, Labs, and Hospitals. Right! Majid Ali MD from Majid Ali on Vimeo.

First, it provides an opportunity to check and counsel on weight and blood pressure — crucial since one out of four deaths in the United States is from heart disease.

Second, we measure height. Shrinkage correlates with osteoporosis, which, if left untreated, is associated with significant disability and death.

Third, we order cancer screening tests.

Fourth, we ensure that patients are up to date on their vaccines.

Fifth, the physical fulfills my office’s requirement of a once yearly visit for any patient receiving prescriptions.

Finally, though Dr. Emanuel mentions it only briefly, the most important part of the annual physical is the strengthening of the doctor-patient relationship. The better I know my patients, the better I can care for them.

The last point would have been especially relevant if the authors had underscored the importance of issues of toxicities of nutrition, environment, and thoughts.


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One comment

  • I totally agree with skipping the annual exam!

    My Story: Every year from about age 35 up until 2012, I’ve had an annual near my next birthday. My last annual was 2012. During that visit, the PA at the “No Care Station” reads my blood work & announces that my WBC was 1.5 & that I could possibly have lukemia, that she wanted to refer me to a specialist who would stick a needle in my hip to draw some fluid to ascertain how bad off I was–BUT– before I see the specialist, she wanted to run an HIV test because WBCs that low indicated either of the 2. WOW!

    My first & stupid response was ok, lets do the HIV test & I’ll call the specialist. I walked in there feeling great & walked out questioning my husband’s fidelity, worrying about my will, & physically I felt so sick I called in work the next day.

    While at home, I shook myself off, took a shower & started reading. Then, I realized that I just meet that woman, 2nd she’s not a doctor she’s a physician’s assistant, & 3rd, I’m not going to any specialist whose job it is to get patients! Of course he’ll find something wrong — how else does he make his money. LAST & most importantly, it was DECEMBER in NJ!!! I’m indoors most of the day, & I know that 15 minutes of sunlight (Vitamin D) would up those numbers.

    I did’nt see a specialist nor did I go back there. A week later, she calls me at work & says, oh I was worried about you & wanted to check up on you. I was not so kind . . . I said listen, I don’t know you & I did not walk in looking for trouble. For you to tell me I could have blood cancer or HIV was stupid of you & don’t call me again.

    She said, well, I was just worried about you . . . I said you don’t know me, so stop it already & I hung up.

    It’s now 2015, I’m still here! Those numbers increased 4 fold by going for a walk each day! And I feel fantastic. I’m overweight (who isn’t) but I dance ballet & do water aerobics 2x a week.

    All that being said: The only thing I get on a regular is swimmers ear & hen I can’t treat it myself, I go to the dr. Working on candida & I believe it too will go away for good. Peace.

    Like

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