New study likely to fuel debate over annual phys...( PITTSBURGH Sept. 24 While most pati...),Health

PITTSBURGH, Sept. 24 While most patients and physicians believe its important for adults to have an annual physical exam, theres growing debate about this conventional wisdom. A new study published in the Sept. 24 issue of the Archives of Internal Medicine raises serious questions about the hefty costs and uneven content of these already controversial examinations.

In the first study to systematically quantify the number, cost and content of preventive health and preventive gynecological exams, the studys authors found that an estimated 44.4 million adults a year in the United States, or nearly 21 percent, receive a preventive physical exam, while about 19.4 million women, or 18 percent, receive a preventive gynecological exam. The total costs of these exams and associated preventive services are approximately $5.2 billion and $2.6 billion a year respectively, the researchers calculated nearly equal to the $8.1 billion spent on all breast cancer care in 2004.

Although annual exams are not recommended by any major North American clinical organization, our health system is clearly devoting a great deal of time, money and resources to them, noted Ateev Mehrotra, M.D., M.P.H., lead author of the study, assistant professor at the University of Pittsburgh School of Medicine and a policy analyst at RAND Corp. Most patients believe they should see a doctor every year for a physical in which the doctor will examine them from head to toe and order lots of tests. There are many doctors who disagree. Physicians need to reach greater consensus on what we should advise patients to do, he added.

The researchers examined data on ambulatory visits from Jan. 1, 2002 to Dec. 31, 2004, obtained from the National Ambulatory Medical Care Survey and the outpatient component of the National Hospital Ambulatory Medical Care Survey. Their analysis of this nationally representative data showed that preventive health and gynecological exams account for one i
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