Do healthy young adults need a yearly physical?

January 19, 2015

Ezekiel J. Emanuel, M.D., an oncologist and vice provost at the University of Pennsylvania, recently wrote an op-ed piece for the New York Times called “Skip Your Annual Physical.” He stated his new year’s resolution was to skip his check-up with his primary care provider. He said it was one small way he could help reduce health care costs – because, from a health perspective, the exam was “basically worthless.”

That’s a pretty bold statement – one which might cause head scratching and confusion among the general population. After all, it goes against everything we’ve been told. And while his article makes some valid points, I don’t agree with his assessment that there’s no value in regular visits with your primary care provider unless you have a medical issue or complaint.

Getting to know you

Probably the most important aspect of regular visits with your primary care provider is relationship building. You might not have any medical issues today – but what happens tomorrow when you do? As a doctor and a patient, I believe there’s tremendous value in establishing a relationship with a provider in times of good health. Then, when you find yourself in need of help, you have someone to turn to – someone who is already familiar with your medical history and general health.

As a primary care provider, I see value in regular visits with my patients to update their family medical history, monitor their overall health and recommend healthy habits, including:

  • Immunizations: flu, tetanus, measles, chickenpox, shingles and pneumonia (depending a patient’s age and overall health)
  • Healthy living: smoking cessation, balanced diet, regular exercise, proper sleep
  • Regular screenings: mammograms, pap tests, STD testing (as appropriate)

How often should you see your primary care provider?

Kids see their pediatric or family medicine provider for vaccinations and regular well-child checks. Older adults or patients with chronic medical conditions see their primary care providers at least yearly. But what if your age falls somewhere in between? Screening tests notwithstanding, you might ask, “I’m in good health and I feel fine, so why do I need to see the doctor every year?”

The answer: you don’t. This is where I agree – to some degree – with Dr. Emanuel.

Recent studies show that yearly physicals for overall healthy, young adults are unnecessary. So if you’re an adult between the ages of 18 and 30, you don’t smoke or take prescription medications and you maintain a healthy weight, you’re safe with a physical every two or three years. If you’re between the ages of 30 and 40, you should get a physical every other year.

However, if you’re a sexually active woman, it’s important to have regular pap smears to screen for cervical cancer and STD testing if your health and lifestyle put you at greater risk. Based on your overall health and family medical history, your primary care provider will make a recommendation as to how often these tests are necessary.

If you have chronic disease factors like high blood pressure and high cholesterol or if you’re overweight, you should see your doctor every year. These factors can lead to chronic diseases, if not kept in check, and seeing your doctor regularly can encourage a healthy lifestyle.

Yearly physicals are recommended for everyone beginning at age 50. This is also the time to have your first colonoscopy to screen for colon cancer.

It’s not a one-size-fits-all proposition

Maybe “skip your annual physical” isn’t the best message to spread to the masses. Really, there isn’t a “one-size-fits-all” formula for health care. Every patient is different and needs a plan tailored to their individual needs. And, the best way to formulate that plan is to establish a relationship with a primary care provider and work together to decide what’s best for you.

Sure, you might be able to save a few bucks today. But, more importantly, you’ll put a plan in motion to receive better, more tailored care in the future.

Topics: Wellness