6 ms·

In Canada, my "free healthcare" doctor doesn't even do annual physicals, so...

ceejayoz 3y ago
That might be the right call. https://www.health.harvard.edu/blog/a-checkup-for-the-checkup-do-you-really-need-a-yearly-physical-201510238473 https://www.health.harvard.edu/blog/a-checkup-for-the-checku... > Careful reviews of several large studies have shown that these annual visits don't make any difference in health outcomes. In other words, being seen by your doctor once a year won't necessarily keep you from getting sick, or even help you live longer. And some of the components of an annual visit may actually cause harm. For example, lab tests and exams that are ordered for healthy patients (as opposed to people with symptoms or known illnesses) are statistically more likely to be "false positives" — that is, when test results suggest a problem that doesn't exist. Even if these inaccurate findings affect only a tiny percentage of the more than 200 million adults who would undergo such exams, the monetary, practical, and emotional costs are huge.
- JoshTriplett 3y ago
  That sounds less like the exams are the problem, and more like the incorrect handling of false positives is the problem.
  - gruez 3y ago
    >and more like the incorrect handling of false positives is the problem. And what would be the "correct" way of handling it? Remember, you don't know that the test returned positive, not that it's a false positive or not. Are you going to tell the patient, "your breast cancer test returned positive, but given your age and other risk factors the probability that you actually have breast cancer is pretty low, so we won't do anything about it"? Even if that's the right thing to do from a statistical perspective, can you imagine the public outrage directed at the bureaucrat/politician that implemented this policy, if it turned out the patient did have breast cancer and died 2 years later?
    - JoshTriplett 3y ago
      Definitely not "we won't do anything about it". The medical industry (and frankly many other things but especially the medical industry) needs to find an effective way to present the common result "this test returned positive, but given the base rate in the population and the accuracy of this test, this is not necessarily enough information and your probability of having X is still only Y%, so we're going to run another non-invasive test to see if there's even enough information to warrant doing a more detailed check; ZZ% of people get a negative on the second test". Perhaps find a nice graphical presentation of the simplest version of Bayes Rule: "the base rate in the population is this, here's what the test means for the part of the population that doesn't have it, here's what the test means for the part that does, here's how your probability went up but that it's still vastly more likely you don't have it than that you do."
- throwaway4good 3y ago
  Japan is famous for doing an extensive annual health check …
  - ceejayoz 3y ago
    Perhaps they shouldn’t.
- eftychis 3y ago
  That is [an] incorrect conclusion to make. In other developed (or even developing) countries, going to a doctor if you feel anything is not a financial question. You just go. Also annual bloodwork -- without needing to even do a doctor visit -- is sometimes a thing. You can go to the specialist you think you need. Got a heart/chest issue: you go to the specialist and do not worry if it is covered or how to pay them. Disclaimer: lived/live for years in both Europe and U.S. I also have a glimpse of how the japanese system works and South America a bit too. These things are not comparable. You would think North Americas are a different "world far far away." tl;dr: I find the average in the U.S. surprising. Then I look at the median life expectancy.
  - ceejayoz 3y ago
    I agree it’s better when folks don’t have to worry about affording healthcare. I’d like a single-payer universal system here. That doesn’t mean an annual physical is good for you.
    - eftychis 3y ago
      Annual physical in the U.S. is one's chance to get a "relatively free" doctor visit for an issue they have. The conclusion that if you are healthy there is a higher chance to have a false positive is misleading. a) that is true by definition: they have asserted the patients are healthy already; b) statement assumes that in the U.S. people go to the doctor at the same rate as they go in other countries; and thus have a chance to test themselves / do checkups necessary to their particular family/individual risk profile; So drawing the directive that annual physicals are to be discarded is hypocritical. And to be substituted with "questionnaires" is .. [well I don't really have words.] They are stretching for a conclusion to remove the ~free annual requirement. (cc from your linked blog study/recommendation): > Second, they acknowledge that if the annual visit is to be discarded, primary care doctors will need to find a more proactive way to monitor their patients' attention to preventive care. They suggest that waiting for patients to keep their annual visits to review this is too "passive" an approach, and encourage practices to shift to "active engagement" of their patients. Ways to do this might include: online risk assessments, waiting-room questionnaires, and a review of preventive care at any visit to the doctor.
throwaway4good 3y ago
Not a thing in Denmark either.
galactus 3y ago
And yet we have a quite higher life expectancy than the US
- rootusrootus 3y ago
  Things like obesity and life expectancy vary considerably across the US, which makes drawing broad conclusions pretty difficult. Try comparing regions that are closer, like BC to Washington state.
  - galactus 3y ago
    Sure, but still, the difference between BC and Washington state (~2 years higher in BC) is greater than the difference between Washington state and Texas.
morkalork 3y ago
At least you have a doctor, all I've got is a spot on a waiting and walk-in clinics you can't walk-in to without making an appointment in advance!
simonjgreen 3y ago
Not from US, but whenever I hear about US folks having an annual physical it reminds me of the Scrubs episode on full body scans
benj111 3y ago
I've never come across it in the UK either. Once you're past a certain age there's mammograms and stuff though.
jeroenhd 3y ago
I have the feeling this is only a thing in certain countries. I've never heard of anyone healthy getting yearly physical here in Europe (seeing the GP is almost always free so you could do it if you want, but the doctor will wonder why you're wasting his time unless you have symptoms/suspicions/etc to report or ask). Of course chronically ill or very old people are getting tested regularly, but only for stuff specifically for their illness/situation. Doesn't stop the "full body scan" ads on YouTube of course, but that's something you'll have to pay for out of pocket and most GPs will recommend against them as far as I know. It seems to be a very USA-specific concept, but I can't say for sure no other countries do it. I think Japan does it? I don't think it's common in Canada, is it?
rootusrootus 3y ago
In the US, my HMO doc will do one only if I insist. Even my previous PPO doc was pretty relaxed about it. He said it was up to me if I wanted to do it, but that it wouldn't really be useful. Certainly there are people in the US that go for a physical every year, but many of us do not. In my wider circle of friends and family, very few of us bother.
johntiger1 3y ago
But you can visit them whenever you want. It's a huge benefit when you can visit the doctor without worrying whether or not you can pay for it

That might be the right call. https://www.health.harvard.edu/blog/a-checkup-for-the-checkup-do-you-really-need-a-yearly-physical-201510238473 https://www.health.harvard.edu/blog/a-checkup-for-the-checku... > Careful reviews of several large studies have shown that these annual visits don't make any difference in health outcomes. In other words, being seen by your doctor once a year won't necessarily keep you from getting sick, or even help you live longer. And some of the components of an annual visit may actually cause harm. For example, lab tests and exams that are ordered for healthy patients (as opposed to people with symptoms or known illnesses) are statistically more likely to be "false positives" — that is, when test results suggest a problem that doesn't exist. Even if these inaccurate findings affect only a tiny percentage of the more than 200 million adults who would undergo such exams, the monetary, practical, and emotional costs are huge.

JoshTriplett 3y ago
That sounds less like the exams are the problem, and more like the incorrect handling of false positives is the problem.
- gruez 3y ago
  >and more like the incorrect handling of false positives is the problem. And what would be the "correct" way of handling it? Remember, you don't know that the test returned positive, not that it's a false positive or not. Are you going to tell the patient, "your breast cancer test returned positive, but given your age and other risk factors the probability that you actually have breast cancer is pretty low, so we won't do anything about it"? Even if that's the right thing to do from a statistical perspective, can you imagine the public outrage directed at the bureaucrat/politician that implemented this policy, if it turned out the patient did have breast cancer and died 2 years later?
  - JoshTriplett 3y ago
    Definitely not "we won't do anything about it". The medical industry (and frankly many other things but especially the medical industry) needs to find an effective way to present the common result "this test returned positive, but given the base rate in the population and the accuracy of this test, this is not necessarily enough information and your probability of having X is still only Y%, so we're going to run another non-invasive test to see if there's even enough information to warrant doing a more detailed check; ZZ% of people get a negative on the second test". Perhaps find a nice graphical presentation of the simplest version of Bayes Rule: "the base rate in the population is this, here's what the test means for the part of the population that doesn't have it, here's what the test means for the part that does, here's how your probability went up but that it's still vastly more likely you don't have it than that you do."
throwaway4good 3y ago
Japan is famous for doing an extensive annual health check …
- ceejayoz 3y ago
  Perhaps they shouldn’t.
eftychis 3y ago
That is [an] incorrect conclusion to make. In other developed (or even developing) countries, going to a doctor if you feel anything is not a financial question. You just go. Also annual bloodwork -- without needing to even do a doctor visit -- is sometimes a thing. You can go to the specialist you think you need. Got a heart/chest issue: you go to the specialist and do not worry if it is covered or how to pay them. Disclaimer: lived/live for years in both Europe and U.S. I also have a glimpse of how the japanese system works and South America a bit too. These things are not comparable. You would think North Americas are a different "world far far away." tl;dr: I find the average in the U.S. surprising. Then I look at the median life expectancy.
- ceejayoz 3y ago
  I agree it’s better when folks don’t have to worry about affording healthcare. I’d like a single-payer universal system here. That doesn’t mean an annual physical is good for you.
  - eftychis 3y ago
    Annual physical in the U.S. is one's chance to get a "relatively free" doctor visit for an issue they have. The conclusion that if you are healthy there is a higher chance to have a false positive is misleading. a) that is true by definition: they have asserted the patients are healthy already; b) statement assumes that in the U.S. people go to the doctor at the same rate as they go in other countries; and thus have a chance to test themselves / do checkups necessary to their particular family/individual risk profile; So drawing the directive that annual physicals are to be discarded is hypocritical. And to be substituted with "questionnaires" is .. [well I don't really have words.] They are stretching for a conclusion to remove the ~free annual requirement. (cc from your linked blog study/recommendation): > Second, they acknowledge that if the annual visit is to be discarded, primary care doctors will need to find a more proactive way to monitor their patients' attention to preventive care. They suggest that waiting for patients to keep their annual visits to review this is too "passive" an approach, and encourage practices to shift to "active engagement" of their patients. Ways to do this might include: online risk assessments, waiting-room questionnaires, and a review of preventive care at any visit to the doctor.

throwaway4good 3y ago

Not a thing in Denmark either.

galactus 3y ago

And yet we have a quite higher life expectancy than the US

rootusrootus 3y ago
Things like obesity and life expectancy vary considerably across the US, which makes drawing broad conclusions pretty difficult. Try comparing regions that are closer, like BC to Washington state.
- galactus 3y ago
  Sure, but still, the difference between BC and Washington state (~2 years higher in BC) is greater than the difference between Washington state and Texas.

morkalork 3y ago

At least you have a doctor, all I've got is a spot on a waiting and walk-in clinics you can't walk-in to without making an appointment in advance!

simonjgreen 3y ago

Not from US, but whenever I hear about US folks having an annual physical it reminds me of the Scrubs episode on full body scans

benj111 3y ago

I've never come across it in the UK either. Once you're past a certain age there's mammograms and stuff though.

jeroenhd 3y ago

I have the feeling this is only a thing in certain countries. I've never heard of anyone healthy getting yearly physical here in Europe (seeing the GP is almost always free so you could do it if you want, but the doctor will wonder why you're wasting his time unless you have symptoms/suspicions/etc to report or ask). Of course chronically ill or very old people are getting tested regularly, but only for stuff specifically for their illness/situation. Doesn't stop the "full body scan" ads on YouTube of course, but that's something you'll have to pay for out of pocket and most GPs will recommend against them as far as I know. It seems to be a very USA-specific concept, but I can't say for sure no other countries do it. I think Japan does it? I don't think it's common in Canada, is it?

rootusrootus 3y ago

In the US, my HMO doc will do one only if I insist. Even my previous PPO doc was pretty relaxed about it. He said it was up to me if I wanted to do it, but that it wouldn't really be useful. Certainly there are people in the US that go for a physical every year, but many of us do not. In my wider circle of friends and family, very few of us bother.

johntiger1 3y ago

But you can visit them whenever you want. It's a huge benefit when you can visit the doctor without worrying whether or not you can pay for it