Task force recommends elimination of annual checkups

Annual physical checkups yield few benefits and should be abolished, urges a Canadian task force, headed by a senior investigator in the Lady Davis Institute (LDI) at the JGH.

Dr. Brett Thombs

As an alternative to yearly visits, the Canadian Task Force on Preventive Health Care recommends that patients be instructed about regularly performing health prevention activities that are appropriate for their age.

In an article published in November in the journal Canadian Family Physician, members of the task force express concern that annual checkups can lead to over-diagnosis. This can reveal conditions of uncertain clinical importance, resulting in anxiety among patients and, possibly, unnecessary medical intervention.

“A long-standing argument has been that annual, non-specific doctor-patient encounters will lead to better health outcomes, but the evidence simply doesn’t support it,” says Dr. Brett Thombs, who chairs the task force and is a Professor in the Faculty of Medicine at McGill University.

However, Dr. Thombs emphasizes that individuals should see a primary care doctor to treat an illness, manage a chronic condition, or get information about age-appropriate prevention activities.

There is also value in periodic visits to primary care physicians for specific prevention activities, he says. For example, women around the age of 50 should see their doctor to discuss the possible benefits and harm of undergoing mammography screening for breast cancer. Similarly, men over 65 should discuss screening for conditions such as abdominal aortic aneurysms.

Elimination of the annual physical exam was initially recommended in 1978 by the Canadian Task Force on the Periodic Health Examination. It favoured an age-specific approach that emphasizes the identification and early management of potentially preventable conditions.

“We have known for many years that having an annual physical checkup has very little benefit for healthy individuals and may have some harm,” says Dr. Richard Birtwhistle, first author on the article and Professor of Family Medicine and Public Health Sciences at Queen’s University.

“We want to change the conversation to focus on the delivery of preventive services through periodic preventive health visits and those things that we know may benefit an individual’s health.”