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There is no real medical need for an ‘annual physical’ it is a creation of the American medical-industrial complex and creates more problems than it solves. Ha

There is no real medical need for an ‘annual physical’ it is a creation of the American medical-industrial complex and creates more problems than it solves. Having said that seeing a doctor occasionally for blood pressure etc is useful, but the interval for someone young and otherwise not experiencing any symptoms doesn’t need to be annually

mrmuagi 5y ago
Isn't there catch-it-early type diseases? Like breast cancer, testicular cancer, colon cancer, etc... that prove this wrong? The funny thing is, the older you get, you are likely to have some sort of symptom. Such is life. For blood pressure, I would expand and add general bloodwork for health conscious individuals or people with a family history for certain issues -- diabetes, liver, androgen, heart health markers.. Here in Canada you just need to mention you are interested for health reasons and a doctor refers you -- not sure how costly it is in USA -- but apparently private clinics are a choice to build custom panels.
- franga2000 5y ago
  I've heard many experts talk about issues with "catching disease early", one being that what doctors find might have never developed far enough to cause harm and so the treatment might actually be more harmful. I don't want to risk trying to explain it from memory since I have zero medical knowledge, but there's a YouTube video by "MedlifeCrisis" about this that also has sources cited in the description. The title is something like "the problem with screening".
  - throwaway4aday 5y ago
    > one being that what doctors find might have never developed far enough to cause harm and so the treatment might actually be more harmful. This is not a reason to not screen regularly. If treating very early is the problem then you should still aim to detect it early and then closely monitor it until you have enough information to decide whether to act or not. There are many people that will simply not go in for testing until there is a major problem if you advise against regular testing. A close family member of mine just passed away recently because he didn't go in for regular testing and they caught the cancer way too late.
- robbiep 5y ago
  For ‘catch it early’ you are talking screening. That’s why there’s cervical cancer screening (pap smear/the new cytology test), mammograms, faecal occult blood tests, in australia skin cancer screening, etc. And that’s why people should have a regular doctor and that’s why as you get older you see your doctor more frequently. But for young(ish) otherwise healthy people, the whole concept of something ther occurs annually doesnt make sense. In the other hand, since most screening and medical engagement is with females, you are left with lots of men who get into their 40s without ever having seen a doctor. So - if thats you - go and see one, build a relationship, and if everything is good ask when you need to come back for prostate screening, FOBT, cholesterol or anything else. All across the board is unnecessary. With regards to your last point, I’m all for devolving autonomy and power to the patient, but frankly across the board wide ranging blood testing (especially regularly) just doesn’t make sense for a significant percentage of people, unless there is a high pre test probability or a significant family history. All blood results are managed at the 95% CI so if you go in and have 20+ blood tests then more than likely at least one is going to be out of order. All you need to do is visit the askdocs subreddit to see the immense anxiety and flow down effects that has on a population who have absolutely no way of understanding a slightly out of bounds result. Those private clinics trying to spin up and do ‘wellness checks’ are frankly in my opinion, and until the evidence proves otherwise, a parasite on the worried well
  - xeromal 5y ago
    Shouldn't you at least do regular blood panels to check for prediabetes and the like?
    - robbiep 5y ago
      If a person is otherwise healthy, no. Or at least, there is no medical indication to do so. But a person with pre diabetes is not generally otherwise healthy. T2DM is not a condition of a healthy person, it is a lifestyle disease caused by lack of exercise, poor diet and obesity. This person should see a doctor, but they’re not a healthy person. They should be aiming to exercise and reduce body mass.
pkaye 5y ago
> There is no real medical need for an ‘annual physical’ it is a creation of the American medical-industrial complex and creates more problems than it solves. What problems does it create? Isn't preventive care a good thing? Also Japan does annual physicals much more rigorous that in the US. I wish what is done in the US was more rigorous because it would have caught the autoimmune disease that caused my kidney failure. Unfortunately by the time there are visible symptoms, the damage cannot be reversed.
- retrac 5y ago
  Medicine can hurt as well as heal. A concrete example. Many doctors will advise you not to get a full body MRI scan. You can pretty easily buy such a service, and hire some radiologists to pour over every cubic millimetre of your body. But it's a really bad idea. Because they will almost certainly find something ambiguous or troubling. And they're gonna biopsy. And then, well, maybe that's ambiguous. Another biopsy. You're terrified, the doctor's now worried about something they would never have known about otherwise, and maybe you have surgery to get it early. In the end the complications of all that quite potentially add up to a shorter life expectancy than simply not getting scanned in the first place. On average. Though of course, if you had a giant treatable tumour that shows up, well, you'd want the scan. But most people don't have one, and all those interventions can cause harm.
  - MPSimmons 5y ago
    There are a couple of orders of magnitude difference between findings from a full-body MRI and a routine labwork run.
  - Footkerchief 5y ago
    The correct takeaway is to use information responsibly, not to deny yourself information.
    - robbiep 5y ago
      I agree in principle, but health literacy is so appallingly low - globally - that more often than not people are not equipped to deal with this information. As I said in an earlier post on this thread, look at the askdocs subreddit. 90% of the posts there are worried well asking for clarification of some unnecessary test they went and specifically asked a doctor for, the result of which they don’t understand and which is causing a cascade of health anxiety. If every person understood enough to realise how many ‘abnormalities’ enough investigations would show up, and how in 99% of people they mean absolutely nothing, then it would be fine. But that’s not our current situation. And if you’re one of those people who are capable of parsing the dense health literature and understanding the implications (or not) of ‘normal abnormal’ findings, then go for it. But for the population as a whole? It’s not viable or helpful
WheatM 5y ago
astrange 5y ago
It's a legal requirement for employers in Japan and they seem to have come up with it on their own. https://www.city-cost.com/blogs/City-Cost/MPyry-medical https://www.city-cost.com/blogs/City-Cost/MPyry-medical Being Japan, it's pointlessly thorough and invasive.
- EE84M3i 5y ago
  The most invasive part is that they send the results to your employer. I initially balked at this, but you effectively don't have a choice if you want to work at a big company in Japan, although it's worth noting the legal requirement is on the employer to get the tests done, not on the employee to do it.

mrmuagi 5y ago

Isn't there catch-it-early type diseases? Like breast cancer, testicular cancer, colon cancer, etc... that prove this wrong? The funny thing is, the older you get, you are likely to have some sort of symptom. Such is life. For blood pressure, I would expand and add general bloodwork for health conscious individuals or people with a family history for certain issues -- diabetes, liver, androgen, heart health markers.. Here in Canada you just need to mention you are interested for health reasons and a doctor refers you -- not sure how costly it is in USA -- but apparently private clinics are a choice to build custom panels.

franga2000 5y ago
I've heard many experts talk about issues with "catching disease early", one being that what doctors find might have never developed far enough to cause harm and so the treatment might actually be more harmful. I don't want to risk trying to explain it from memory since I have zero medical knowledge, but there's a YouTube video by "MedlifeCrisis" about this that also has sources cited in the description. The title is something like "the problem with screening".
- throwaway4aday 5y ago
  > one being that what doctors find might have never developed far enough to cause harm and so the treatment might actually be more harmful. This is not a reason to not screen regularly. If treating very early is the problem then you should still aim to detect it early and then closely monitor it until you have enough information to decide whether to act or not. There are many people that will simply not go in for testing until there is a major problem if you advise against regular testing. A close family member of mine just passed away recently because he didn't go in for regular testing and they caught the cancer way too late.
robbiep 5y ago
For ‘catch it early’ you are talking screening. That’s why there’s cervical cancer screening (pap smear/the new cytology test), mammograms, faecal occult blood tests, in australia skin cancer screening, etc. And that’s why people should have a regular doctor and that’s why as you get older you see your doctor more frequently. But for young(ish) otherwise healthy people, the whole concept of something ther occurs annually doesnt make sense. In the other hand, since most screening and medical engagement is with females, you are left with lots of men who get into their 40s without ever having seen a doctor. So - if thats you - go and see one, build a relationship, and if everything is good ask when you need to come back for prostate screening, FOBT, cholesterol or anything else. All across the board is unnecessary. With regards to your last point, I’m all for devolving autonomy and power to the patient, but frankly across the board wide ranging blood testing (especially regularly) just doesn’t make sense for a significant percentage of people, unless there is a high pre test probability or a significant family history. All blood results are managed at the 95% CI so if you go in and have 20+ blood tests then more than likely at least one is going to be out of order. All you need to do is visit the askdocs subreddit to see the immense anxiety and flow down effects that has on a population who have absolutely no way of understanding a slightly out of bounds result. Those private clinics trying to spin up and do ‘wellness checks’ are frankly in my opinion, and until the evidence proves otherwise, a parasite on the worried well
- xeromal 5y ago
  Shouldn't you at least do regular blood panels to check for prediabetes and the like?
  - robbiep 5y ago
    If a person is otherwise healthy, no. Or at least, there is no medical indication to do so. But a person with pre diabetes is not generally otherwise healthy. T2DM is not a condition of a healthy person, it is a lifestyle disease caused by lack of exercise, poor diet and obesity. This person should see a doctor, but they’re not a healthy person. They should be aiming to exercise and reduce body mass.

pkaye 5y ago

> There is no real medical need for an ‘annual physical’ it is a creation of the American medical-industrial complex and creates more problems than it solves. What problems does it create? Isn't preventive care a good thing? Also Japan does annual physicals much more rigorous that in the US. I wish what is done in the US was more rigorous because it would have caught the autoimmune disease that caused my kidney failure. Unfortunately by the time there are visible symptoms, the damage cannot be reversed.

retrac 5y ago
Medicine can hurt as well as heal. A concrete example. Many doctors will advise you not to get a full body MRI scan. You can pretty easily buy such a service, and hire some radiologists to pour over every cubic millimetre of your body. But it's a really bad idea. Because they will almost certainly find something ambiguous or troubling. And they're gonna biopsy. And then, well, maybe that's ambiguous. Another biopsy. You're terrified, the doctor's now worried about something they would never have known about otherwise, and maybe you have surgery to get it early. In the end the complications of all that quite potentially add up to a shorter life expectancy than simply not getting scanned in the first place. On average. Though of course, if you had a giant treatable tumour that shows up, well, you'd want the scan. But most people don't have one, and all those interventions can cause harm.
- MPSimmons 5y ago
  There are a couple of orders of magnitude difference between findings from a full-body MRI and a routine labwork run.
- Footkerchief 5y ago
  The correct takeaway is to use information responsibly, not to deny yourself information.
  - robbiep 5y ago
    I agree in principle, but health literacy is so appallingly low - globally - that more often than not people are not equipped to deal with this information. As I said in an earlier post on this thread, look at the askdocs subreddit. 90% of the posts there are worried well asking for clarification of some unnecessary test they went and specifically asked a doctor for, the result of which they don’t understand and which is causing a cascade of health anxiety. If every person understood enough to realise how many ‘abnormalities’ enough investigations would show up, and how in 99% of people they mean absolutely nothing, then it would be fine. But that’s not our current situation. And if you’re one of those people who are capable of parsing the dense health literature and understanding the implications (or not) of ‘normal abnormal’ findings, then go for it. But for the population as a whole? It’s not viable or helpful

WheatM 5y ago

astrange 5y ago

It's a legal requirement for employers in Japan and they seem to have come up with it on their own. https://www.city-cost.com/blogs/City-Cost/MPyry-medical https://www.city-cost.com/blogs/City-Cost/MPyry-medical Being Japan, it's pointlessly thorough and invasive.

EE84M3i 5y ago
The most invasive part is that they send the results to your employer. I initially balked at this, but you effectively don't have a choice if you want to work at a big company in Japan, although it's worth noting the legal requirement is on the employer to get the tests done, not on the employee to do it.