The Norman Transcript

Community News Network

August 20, 2013

The case against the annual checkup

(Continued)

"In a urinalysis, doctors look for protein or blood in the urine to check for chronic kidney disease," explains Ateev Mehrotra, a doctor who studies health care policy at Harvard Medical School and the RAND Corporation. "If it's positive, you do a repeat. If that's positive, you ultrasound the kidney and then possibly do a biopsy. The risk is low, but kidney biopsy can lead to hemorrhage and even kidney removal."

Kidney biopsies are perfectly reasonable procedures when a patient has symptoms of kidney disease. But looking for disease in an otherwise healthy patient, then performing a series of interventions to prove the screening test wrong — that's bad medicine.

There's also the risk of unnecessarily "medical-izing" minor illness. People who go for annual checkups typically report symptoms that they would have otherwise ignored. In some cases, that's a good thing — some patients minimize their symptoms and ignore the warning signs of serious illness. Most of the time, however, it forces the physician to investigate and treat a problem that would have gone away on its own.

(Optional add end)

There's one largely unmeasurable argument in favor of the annual checkups: They build relationships between doctor and patient, and open lines of communication are important in medicine. That's a valid point, but that benefit has to be weighed against the costs.

"The average bank teller 20 years ago would have argued that the ATM prevents them from building important relationships with their clients, and bank customers would have agreed," notes Mehrotra. "But time is valuable, too, and we shouldn't forget that."

Mehrotra points out that an average patient likely takes two hours off of work for a doctor's appointment. If you multiply that by the average wage and total number of annual checkups in a year, these appointments cost the U.S. economy almost $2 billion in lost productivity alone. Relationship building probably isn't worth that much, especially since you can catch up with your primary-care doctor when you're ill.

In addition, while you're spending time getting to know your doctor, chatting about your hobbies and your grandparents, there are other patients waiting weeks or months for an appointment. And some of them are actually sick.

Palmer is Slate's chief explainer. He also writes How and Why and Ecologic for the Washington Post. Email him at explainerbrian@gmail.com.

Text Only | Photo Reprints
Community News Network
  • Why a see-through mouse is a big deal for scientists

    A group of Caltech researchers announced in Cell Thursday their success in making an entire organism transparent. Unfortunately, this isn't any kind of "Invisible Man" scenario: The organism in question is a mouse, and the mouse in question is quite dead.

    July 31, 2014

  • Screen Shot 2014-07-31 at 2.12.55 PM.png VIDEO: Five-year-old doesn't want her brother to grow up

    Sadie, an adorable 5-year-old from Phoenix, wants her brother to stay young forever, so much so that her emotional reaction to the thought of him getting older has drawn more than 10 million views on YouTube.

    July 31, 2014 1 Photo

  • lockport-police.jpg Police department turns to Facebook for guidance on use of 'negro'

    What seems to be a data entry mistake by a small town police department in western New York has turned into a social media firestorm centered around the word "negro" and whether it's acceptable to use in modern society.

    July 31, 2014 3 Photos

  • The virtues of lying

    Two computational scientists set out recently to simulate the effects of lying in a virtual human population. Their results, published in the Proceedings of the Royal Society B, show that lying is essential for the growth of a cohesive social network.

    July 31, 2014

  • Sunburn isn't the only sign of summer that can leave you itchy and blistered

    You've got a rash. You quickly rule out the usual suspects: You haven't been gardening or hiking or even picnicking, so it's probably not a plant irritant such as poison ivy or wild parsnip; likewise, it's probably not chiggers or ticks carrying Lyme disease; and you haven't been swimming in a pond, which can harbor the parasite that causes swimmer's itch.

    July 30, 2014

  • Survey results in legislation to battle sexual assault on campus

    Missouri U.S. Sen. Claire McCaskill joined a bipartisan group of senators Wednesday to announce legislation that aims to reduce the number of sexual assaults on college campuses.

    July 30, 2014

  • An alarming threat to airlines that no one's talking about

    It's been an abysmal year for the flying public. Planes have crashed in bad weather, disappeared over the Indian Ocean and tragically crossed paths with anti-aircraft missiles over Ukraine.

    July 30, 2014

  • Sharknado.jpg Sharknado 2 set to attack viewers tonight

    In the face of another "Sharknado" TV movie (the even-more-inane "Sharknado 2: The Second One," premiering Wednesday night on Syfy), there isn't much for a critic to say except to echo what the characters themselves so frequently scream when confronted by a great white shark spinning toward them in a funnel cloud:
    "LOOK OUT!!"

    July 30, 2014 1 Photo

  • 20140729-AMX-GIVHAN292.jpg Spanx stretches into new territory with jeans, but promised magic is elusive

    The Spanx empire of stomach-flattening, thigh-slimming, jiggle-reducing foundation garments has expanded to include what the brand promises is the mother of all body-shaping miracles: Spanx jeans.

    July 29, 2014 1 Photo

  • Medical marijuana opponents' most powerful argument is at odds with a mountain of research

    Opponents of marijuana legalization are rapidly losing the battle for hearts and minds. Simply put, the public understands that however you measure the consequences of marijuana use, the drug is significantly less harmful to users and society than tobacco or alcohol.

    July 29, 2014