Don’t open wide: Annual check-ups are pretty much useless

January 17, 2013

It might be the most familiar medical procedure: The annual check-up. Doctors screen for harmful diseases and check in on a patient's well-being. And, if a new study is right, they waste lots of health care dollars without making patients any healthier.

Two doctors in Colorado scanned through 14 randomized, controlled studies involving 182,000 patients. The articles spanned from 1963 to 1999. The doctors looked at whether those who had regular check-ups had higher mortality rates than their counterparts who dodged such visits. They could not find a difference.

"General health checks do not improve important outcomes and are unlikely to ever do so based on the pooled results of this meta-analysis spanning decades of experience," write authors Allan Prochazka and Tanner Caverly.  "There remains a belief in the value of general health checks despite the accumulating evidence. This belief is buoyed by screening advocacy groups and insurance coverage, and they have ramifications for patient welfare and health care costs."

Prochazka and Caverly are the first to admit that their findings aren't exactly groundbreaking: Due to the lack of benefits, Canadian guidelines have recommended against general check-ups since 1979. The rationale there is that these visits can do more harm to the patient - and the larger health care system - then good. More from the study:

During these health checks, an estimated $322 million is spent annually on laboratory tests that no guideline groups recommend. The costs of downstream testing and overtreatment are likely to be much larger. For example, the costs of mammography might be $4 billion a year assuming biennial screening. The cost of follow-up biopsies of normal breasts triggered by false-positive mammogram results alone is probably in the range of $14 to $70 billion annually. It is likely that follow-up testing from general health checks substantially contributes to the estimated $210 billion in annual spending on unnecessary medical services.

The United States seemed to be heading in the opposite direction of Canada: The health care law required some insurance plans to cover annual check-ups without a copayment. Even if they don't work, these exams probably aren't leaving the American health care system any time soon.

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