The Cochrane Collaboration is one of the most objective organizations in the world when it comes to analyzing medical data. Experts review the best studies and determine what works and what doesn’t. Their most recent target: regular health check-ups. What they found flies in the face of conventional medical wisdom.
The publication in the Cochrane Library is quite extraordinary.
The investigators assessed 14 trials that included over 180,000 people. Some got regular physical exams and some did not. They then determined the impact of the exams on key health outcomes.
The envelope please: NO DIFFERENCE!
In other words, the people who went in for regular check-ups did not live longer. Their likelihood of dying from heart attacks, strokes or cancer was no different from the people who did not get regular physicals.
This may not come as a great surprise to People’s Pharmacy regular readers (and listeners). Dr. Steve Nissen declared recently on The People’s Pharmacy that annual executive checkups can be counterproductive, subjecting patients to potentially invasive tests that may lead to unnecessary interventions with some risks.
Clearly, there are times when it is important to see the doctor. But the Cochrane Collaboration reviewers suggest that just scheduling an annual checkup doesn’t have a significant benefit, probably because primary care providers are already picking up on the most important risk factors (such as really high blood pressure, for example) when they see patients who are ill.
The reviewers noted that they are not completely pleased with their analysis, because so many of the studies were fairly old, and not all of them were of the highest quality.
Just the same, most People’s Pharmacy readers can probably identify their own risk factors. We all know that smoking increases the risk for multiple conditions, ranging from cancer and heart disease to erectile dysfunction and wrinkles. We can look in the mirror and see if we need to lose some weight, though the value of weight as a predictor of future health is still rather controversial. But there’s consistent evidence that regular physical activity and a good level of fitness help stave off a wide range of health problems. Do you need your doctor to ask you about your exercise regimen, or can you motivate yourself to get moving?
Unless you are ill or have a chronic condition that needs medical care, using common sense and following your grandmother’s wisdom about staying healthy might do more good than that yearly appointment for a general checkup. When you do see your doctor, make sure that you go prepared to make the most of the visit.
The People's Perspective on Medicine