By Sally Farhat for MSN Health & Fitness

It’s time to visit the doctor for your annual checkup.

Or is it?

A decade ago, the U.S. Preventive Services Task Force, a group commissioned by Congress, found that those physical exams you get every year are unnecessary. And more than 20 years ago, a government agency determined that one-size-fits-all annual physicals should be replaced with periodic, individualized exams based on a patient’s health profile. This, however, might be news to your doctor.

Last year, the University of Colorado published a survey that found that physicians were largely unaware of federal guidelines that say healthy, asymptomatic adults do not need an annual exam. Nearly all doctors surveyed think physicals are beneficial because of the bonding that takes place. And, despite its findings, the U.S. Preventive Services Task Force still hasn’t taken an official stance against annual physicals.

“It’s a false dichotomy,” says Dr. Diana Petitti, vice chairwoman of the task force, which continues to research preventive medicine. “You don’t need to see a doctor every year. However, does that mean you should see a doctor only when you’re sick? We stop short of that.”

When should you see your doctor?
If you’re feeling good and haven’t been to the doctor in awhile, don’t fret about never scheduling an annual exam. But if you do have symptoms, while you’re at the doctor, ask him to explain what tests you might need that are unrelated to your present woes. For example, if your family has a history of stroke, after you’re 18, you should keep tabs on your blood pressure. (Read more of the task force’s recommendations on its Web site.)

While there aren’t a slew of tests everyone needs, there are things you do need to check regularly, Dr. Pettiti notes. The task force suggests you see the dentist once or twice a year. But as far as annual medical tests, those depend on your age, family history, gender and personal risk profile. Testing blood pressure and cholesterol and having mammograms and colorectal screenings are services most people should do periodically.

If you have a family history of glaucoma, getting it checked starting at 45 might be a safer bet than the usual 65.

“Obviously, if you’re losing your sight, you’re going to come in,” says New Jersey optometrist Madeline Romeu, who says her contact lens patients have to visit ever year. “I once saw a 17-year-old who said, ‘I see shadows to the left.’ We did a visual field on him and he had a pituitary tumor.”

The allure of tests
But why has this checkup myth permeated for so long? It started in 1961, when a British doctor called for regular screenings for tuberculosis. By 1947, the American Medical Association said everyone over 35 should start having annual physicals. By the 1960s, businessmen were getting “executive physicals”—complete with three days at the hospital for treadmill time, an electrocardiogram and X-rays. This mentality helped create the routine testing of today that’s at the center of the debate.

The task force looked at the range of tests people often go through during physicals and found that most of them have very little yield. One is the CBC, which measures blood glucose levels. The test is used to check for anemia and other problems in the blood that could indicate more serious problems. But, according to the government, the CBC is a test with no proven value for asymptomatic people. Yet, Dr. Allan Prochaska, the lead researcher of the University of Colorado survey, found that 39 percent of doctors order a CBC yearly.

That’s partially because lots of patients think they need these tests and ask for them, Dr. Prochaska says. “Patients just like tests.”

Patients may feel more secure being poked and prodded from every direction, but there’s a downside to getting a slew of tests every year, Dr Prochaska warns: They can create false positives and make you worry for nothing. “If I do 20 laboratory tests on a blood panel, the odds are quite high that one of them is going to be abnormal, and this could be just a random fluctuation,” he says. “Yet, when there’s an abnormal lab test, often that results in a cascade of additional testing that can cost a patient time, money and undue concern.”

But even as much of the routine testing is questioned, there remains strong support for the checkups. As the Colorado survey found, 65 percent of doctors insist the exams are valuable. One of them is Dr. Robert Aschiem, who is affiliated with Executive Health Exams International, a company that performs more than 20,000 annual physicals every year.

“We do tailor exams to the individual,” Dr. Aschiem, an attending physician at New York Presbyterian Hospital, says. “People who claim that annual physicals don’t uncover anything are old-fashioned. Today, you really can make interventions.”
He mentions a healthy patient who came in for a routine visit, and learned he had abnormal blood-sugar levels. The patient also discussed his weight with Dr. Aschiem – he needed to lose about 40 pounds.

Learning of the high blood-sugar, Dr. Aschiem says, was “a hint to take his health seriously.”

Take the middle ground
As you’ve learned, there are no black-and-white answers to this issue. So, what’s a person to do? Should you get an annual exam?
If you just moved to a new city, scheduling a physical exam is an excellent way to build at least a superficial rapport with a doctor. The last thing you want is to be rushed to the ER and have someone who’s never clapped eyes on you or your chart directing your care. A checkup is also a perfect opportunity to assess if a new doctor’s a good fit for you.

Annual exams are a good time, too, to talk about lifestyle challenges to health, such as alcohol consumption, depression, exercise and safe sex. A doctor can encourage healthier choices and sometimes a doctor’s prompt is just what it takes to, say, kick that smoking habit for good.
And that alone could be worth it.

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