Vega, a strapping man with a thick black beard, is feeling good, but he came to see the doctor today because his wife thought he should -- she even made the appointment. It is free to him under his insurance policy with no co-pay, as most preventive care is under the Affordable Care Act
Vega is one of more than 44 million Americans
who is taking part in a medical ritual: visiting the doctor for an annual physical exam. But there's little evidence that those visits actually do any good for healthy adults.
Caruso listens to Vega's heart and lungs, checks his pulse in his ankles and feels around his lymph nodes. He also asks Vega about his exercise and sleeping schedule and orders blood and urine tests. As long as everything checks out, Caruso asks Vega to return for another exam in a year. Vega says he definitely will.
It was a positive experience for both doctor and patient, and they're not alone; 92 percent of Americans say it is important to get an annual head-to-toe physical exam, according to a Kaiser Family Foundation poll
(KHN is an editorially independent program of the foundation). And 62 percent of those polled said they went to the doctor every year for their exam.
But the evidence is not on their side. "I would argue that we should move forward with the elimination of the annual physical," says Dr. Ateev Mehrotra, a primary care physician and a professor of health policy at Harvard Medical School.
Mehrotra says patients should really only go to the doctor if something is wrong, or if it's time to have an important preventive test like a colonoscopy. He realizes popular opinion is against this view. "When I, as a doctor, say I do not advocate for the annual physical, I feel like I'm attacking moms and apple pie," Mehrotra says. "It seems so intuitive and straightforward, and [it's] something that's been part of medicine for such a long time."
But he says randomized trials going back to the 1980s just don't support it.
The Society for General Internal Medici