Anthony L. Komaroff, M.D.
Q. I’m 73 and in great health. Is it okay to skip my annual physical?
A. It all depends on what you mean by “great health” and “annual physical.” I would define “great health” as having no known chronic illnesses. However, most people your age have at least one chronic illness—such as high blood pressure. People with chronic illnesses need to be checked out at least once a year, and usually more often.
I ask all of my patients with no chronic illnesses to come for a check-up every year. A check-up includes some questions, some parts of a physical examination, and some tests. Even though many doctors perform a thorough physical examination of all parts of the body—a “complete physical”—there is not a lot of evidence that this is valuable. I always examine the heart, lungs, abdomen, and skin. Even this limited examination is of unproven value, but I’ve discovered irregular heart rhythms, mild asthma, and the occasional skin cancer. I’m not sure I’ve ever turned up anything important on examining the nose, throat, hands, or feet, however.
What is important to do at least once a year? Asking about any new and bothersome symptoms can occasionally reveal the first evidence of a previously undiagnosed chronic disease. The most important parts of an annual check-up are screening for diseases (using various types of tests) and performing immunizations. As we often discuss in these pages, there are many tests that are effective in catching (and sometimes curing) early diseases—such as various types of cancer and heart disease. And beyond annual flu shots, it is important for adults (not just kids) to get several types of immunizations every so often (see page 3 of this issue).
So, I’d advise you not to skip an annual visit to your doctor. You don’t need to have every nook and cranny of your person probed every year, but you do need certain questions asked, screening tests performed, and immunizations checked.
—Anthony L. Komaroff, M.D.
Editor in Chief
Harvard Health Letter