“When nothing is sure, everything is possible.” Margaret Drabble
Do we need to see a doctor once a year? Some researchers contest the need for the annual check-up suggesting that from a health perspective these visits are useless and irrelevant others believe these are necessary. Let's see what research says.
A few years ago an international group of medical researchers analysed 14 randomised controlled trials with over 182 000 people followed for more than nine years. The purpose of the study was to evaluate the benefits of a general health check-up which they defined as any visit to the physician not prompted by any particular symptom or complaint. The researchers concluded that the appointments were unlikely to be beneficial regardless of which screenings and tests were administered.
Another study showed that the annual check-up did not reduce overall morbidity or mortality from specific causes like cancer or heart disease.
One explanation for this lack of effectiveness in reducing the death rate may be the fact that the check-ups didn't address death or disability from acute conditions. Moreover, screening healthy people with no complaints whatsoever is not the most efficient way of finding potential problems. In fact, only a small percentage may actually be diagnosed.
Although check-ups don't reduce mortality, and some conditions may simply escape detection during a medical examination, there is still value in visiting a doctor once a year.
What if an annual check-up led to an actual diagnosis like prediabetes or cancer? Early diagnosis before the condition has become clinically evident or already too advanced to be treated effectively would lessen human suffering and perhaps save lives.
What we know for sure is that a regular screening tests like mammogram or colonoscopy, an annual flu jab and an overall healthy way of living have proven to reduce both morbidity and mortality.
What happens during a yearly visit?
Sometimes the visit is reduced to a “healthy lifestyle” advice based on the results of individual questionnaires and scores. Other times the array of tests include body weight, blood pressure and simple blood tests like full blood count (FBC), blood glucose, electrolytes (sodium, potassium), creatinine (to check the kidneys), lipid profile, C-reactive protein (CRP, an indicator of an inflammation in a body), and prostate specific antigen (PSA) recommended for men over the age of 50.
An annual check-up may be the first opportunity to spot a high blood pressure and encourage people to revise their lifestyle choices before they develop atrial fibrillation, heart failure, stroke or kidney problems, all of which significantly contribute to increased morbidity and mortality.
The comprehensive check-up is much more than just a quick blood test or a general lifestyle assessment. It is a great opportunity for the patients to spend some time with their doctors in a less rushed visit, to build trust, share concerns and ask meaningful questions. It allows a moment of reflection, gives a better understanding of patient’s worries and aspirations for their health that they wouldn’t express otherwise.
These visits allow a genuine human interaction and raise self-awareness around living and ageing gracefully. It’s easier to discuss these topics when people are well. For some, it may be a wake-up call to take a better care of themselves, for others to take more responsibility for their health.
The annual check-up is a great opportunity to collect baseline data that can be referenced for further medical decision making process in the future. This is a crucial part of an integrated approach focused on both prevention and self-management of chronic conditions.
Does annual check-up help us live longer? Probably not, but it does help keep an updated medical record, gives access to knowledge and encourages to ask intelligent questions which can motivate us to pursue better ways of living.
Yes, a serious disease may rarely be discovered, but it could be, and yes, mortality is unlikely to be affected, but it could be. When nothing is sure, everything is possible.