News and Tribune

Z_CNHI News Service

August 20, 2013

The case against the annual checkup

(Continued)

"In a urinalysis, doctors look for protein or blood in the urine to check for chronic kidney disease," explains Ateev Mehrotra, a doctor who studies health care policy at Harvard Medical School and the RAND Corporation. "If it's positive, you do a repeat. If that's positive, you ultrasound the kidney and then possibly do a biopsy. The risk is low, but kidney biopsy can lead to hemorrhage and even kidney removal."

Kidney biopsies are perfectly reasonable procedures when a patient has symptoms of kidney disease. But looking for disease in an otherwise healthy patient, then performing a series of interventions to prove the screening test wrong — that's bad medicine.

There's also the risk of unnecessarily "medical-izing" minor illness. People who go for annual checkups typically report symptoms that they would have otherwise ignored. In some cases, that's a good thing — some patients minimize their symptoms and ignore the warning signs of serious illness. Most of the time, however, it forces the physician to investigate and treat a problem that would have gone away on its own.

(Optional add end)

There's one largely unmeasurable argument in favor of the annual checkups: They build relationships between doctor and patient, and open lines of communication are important in medicine. That's a valid point, but that benefit has to be weighed against the costs.

"The average bank teller 20 years ago would have argued that the ATM prevents them from building important relationships with their clients, and bank customers would have agreed," notes Mehrotra. "But time is valuable, too, and we shouldn't forget that."

Mehrotra points out that an average patient likely takes two hours off of work for a doctor's appointment. If you multiply that by the average wage and total number of annual checkups in a year, these appointments cost the U.S. economy almost $2 billion in lost productivity alone. Relationship building probably isn't worth that much, especially since you can catch up with your primary-care doctor when you're ill.

In addition, while you're spending time getting to know your doctor, chatting about your hobbies and your grandparents, there are other patients waiting weeks or months for an appointment. And some of them are actually sick.

Palmer is Slate's chief explainer. He also writes How and Why and Ecologic for the Washington Post. Email him at explainerbrian@gmail.com.

Text Only | Photo Reprints
Z_CNHI News Service
  • 20140729-AMX-GIVHAN292.jpg Spanx stretches into new territory with jeans, but promised magic is elusive

    The Spanx empire of stomach-flattening, thigh-slimming, jiggle-reducing foundation garments has expanded to include what the brand promises is the mother of all body-shaping miracles: Spanx jeans.

    July 29, 2014 1 Photo

  • Lindley, Tom.jpg Sideshows involving Rice and Dungy stain NFL's image

    Pro football training camps should be all about, well, football. But the talk around the NFL is about Baltimore Ravens running back Ray Rice's two-game suspension, Tony Dungy's indelicate remarks about Michael Sam and Jim Irsay's largesse. What kind of league is Roger Goodell running?

    July 29, 2014 1 Photo

  • Medical marijuana opponents' most powerful argument is at odds with a mountain of research

    Opponents of marijuana legalization are rapidly losing the battle for hearts and minds. Simply put, the public understands that however you measure the consequences of marijuana use, the drug is significantly less harmful to users and society than tobacco or alcohol.

    July 29, 2014

  • linda-ronstadt.jpg Obama had crush on First Lady of Rock

    Linda Ronstadt remained composed as she walked up to claim her National Medal of Arts at a White House ceremony Monday afternoon.

    July 29, 2014 1 Photo

  • Can black women have it all?

    In a powerful new essay for the National Journal, my friend Michel Martin makes a compelling case for why we need to continue the having-it-all conversation.

    July 29, 2014

  • Dangerous Darkies Logo.png Redskins not the only nickname to cause a stir

    Daniel Snyder has come under fire for refusing to change the mascot of his NFL team, the Washington Redskins. The Redskins, however, are far from being the only controversial mascot in sports history.  Here is a sampling of athletic teams from all areas of the sports world that were outside the norm.

    July 28, 2014 3 Photos

  • 'Rebel' mascot rising from the dead

    Students and alumni from a Richmond, Va.-area high school are seeking to revive the school's historic mascot, a Confederate soldier known as the "Rebel Man," spurring debate about the appropriateness of public school connections to the Civil War and its icons.

    July 28, 2014

  • Fast food comes to standstill in China

    The shortage of meat is the result of China's latest food scandal, in which a Shanghai supplier allegedly tackled the problem of expired meat by putting it in new packaging and shipping it to fast-food restaurants around the country

    July 28, 2014

  • wd saturday tobias .jpg Stranger’s generosity stuns Ohio veteran

    Vietnam War veteran David A. Tobias was overwhelmed recently when a fellow customer at an OfficeMax store near Ashtabula, Ohio paid for a computer he was purchasing.

    July 28, 2014 1 Photo

  • Screen Shot 2014-07-28 at 1.33.11 PM.png VIDEO: High-dive accident caught on tape

    A woman at a water park in Idaho leaped off a 22-foot high dive platform, then tried to pull herself back up with frightening results. Fortunately, she escaped with only a cut to her finger.

    July 28, 2014 1 Photo

LOCAL MAGAZINES
Easter 2014 photos


Click on any photo to purchase it.

SPECIAL CONTENT
Twitter Updates
Follow us on twitter
Hyperlocal Search
Premier Guide
Find a business

Walking Fingers
Maps, Menus, Store hours, Coupons, and more...
Premier Guide
AP Video
Raw: Japanese Soldiers Storm Beach in Exercises Raw: Weapons Fire Hits UN School in Gaza Raw: Rocket Launches Into Space With Cargo Ship Broken Water Main Floods UCLA Two Women Narrowly Avoid Being Hit by Train In Virginia, the Rise of a New Space Coast New Sanctions on Key Sectors of Russian Economy Crayola Announces Family Attraction in Orlando US Ready to Slap New Sanctions on Russia Kerry: Not Worried About Israeli Criticism Boater Rescued From Edge of Kentucky Dam Girl Struck by Plane on Florida Beach Dies Rodents Rampant in Gardens Around Louvre House to Vote on Slimmed-down Bill for Border Looming Demand Could Undercut Flight Safety Raw: 2 Shells Hit Fuel Tank at Gaza Power Plant Raw: Massive Explosions From Airstrikes in Gaza Giant Ketchup Bottle Water Tower Up for Sale Easier Nuclear Construction Promises Fall Short Kerry: Humanitarian Cease-fire Efforts Continue
2013 Photos of the year


Take a look at our most memorable photos from 2013.