Once Over, Less Often? That annual head-to-toe physical may not be the must-do you thought it was. A growing number of experts say the drill may not help prevent disease in healthy adults. The latest voice against: Harvard Women's Health Watch, which outlined the case in its November issue.

The Caveat Here's what Marcie Richardson, a Boston OB-GYN who's on that publication's advisory board, wants instead: targeted screenings keyed to a patient's health status, age, family background and other risk factors. "It's time to reconfigure the concept of the annual exam and have it focused on age-related interventions that we know can improve outcomes," Richardson said. Mary Frank, president of the American Academy of Family Physicians, said her organization has long backed such targeted screenings.

"What's changing is the expectation of what will happen during that [annual] visit," Frank said. Practices such as routinely listening to your heart and lungs and testing your reflexes have not been found useful by the U.S. Preventive Services Task Force, an independent panel that makes research-based health care recommendations. Frank said doctors should use office visits to offer guidance based on a patient's individual circumstances. "If you're a 25-year-old woman who's sexually active," for instance, "the physician can talk with you about what you should do over the next couple of years to keep yourself healthy."

The Connect To find out what tests are recommended for people your age, see www.ahrq.gov/ppip/healthywom.htm (for women) and www.ahrq.gov/ppip/healthymen.htm (for men). Especially for young adults, Frank also suggests developing an ongoing relationship with a physician. "It's hard to get to know your doctor when you have a 104-degree temperature," Frank said. Occasional well visits "allow the doctor to know you as a person, not just a patient with a health problem."

-- Jennifer Huget