Harvard Women's Health Watch

Why regular check-ups are still a good idea

An annual "well woman" visit has important health benefits — especially the doctor-patient relationship it fosters.

For most of the 20th century, the yearly "head-to-toe" physical for adults with no medical complaints was the standard of care, a way to detect disease early and reduce mortality. It typically featured blood tests, urinalysis, and screenings that included a chest x-ray and electrocardiogram. But in the late 1970s, various health groups began to re-evaluate the practice — partly because managed-care organizations wanted to bolster efficiency and reduce costs.

Since then, several authoritative bodies have concluded that healthy adults don't need comprehensive physicals every year. That's the view, for example, of the U.S. Preventive Services Task Force (USPSTF), an expert panel that reviews medical evidence and issues guidelines. The USPSTF and other groups say there's insufficient evidence that such exams actually pay off in the detection and prevention of disease. Instead, these experts recommend that doctors conduct less extensive exams in the course of routine medical care and tailor them to a patient's age, sex, family history, and other individual risk factors. They also hold that procedures and tests should be limited to those of proven preventive value. For women, these include mammography; checking blood pressure, weight, and cholesterol levels; and Pap smears and colon cancer screening. Physicians can remind patients about screenings and counsel them about lifestyle and prevention during visits for various medical reasons.

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