Given the lack of official guidelines on these visits, researchers were not surprised to find significant variations across the country in who gets a physical and in the type of care and testing performed during these exams. For instance, a person who lived in the Northeast was 60 percent more likely to get a physical than someone in the West. This might be due to differences in clinical practice patterns or patient beliefs in different regions, Dr. Mehrotra speculated.
Many of the preventive health exams in the study included laboratory tests, such as complete blood cell counts or urinalyses, that do not clearly improve patient outcomes. More than a third of annual physicals include potentially unnecessary testing at a cost of more than $350 million a year, Dr. Mehrotra estimated. Thats nearly the amount of money that the state of Massachusetts is spending annually to provide insurance to the uninsured.
At the same time, the researchers found that 80 percent of preventive care occurs outside of physical exams, and most patients were seen by physicians for another reason during the same year. This finding supports the idea advocated by some that we should use other visits as an opportunity to deliver preventive care, Dr. Mehrotra said. But he notes that there are important exceptions. In concurrence with previous studies, the researchers found that preventive physicals and preventive gynecological exams were the most common venue for evidence-based preventive services like mammograms and Pap smears.
Dr. Mehrotra and his colleagues hope that their findings will inform future recommendations about the frequency of preventive exams and the feasibility of providing one to all adults in the U
|Contact: Wendy Zellner|
University of Pittsburgh Schools of the Health Sciences