The Annual Check Up Does Not Check Out

Earthshaking news for wellness groupies everywhere: annual check-ups don’t help.  (Thinking Twice About Health Check Ups, Bakalar, New York Times, 10/22/2012)  Why do I hear silence instead of thousands shredders eating brightly colored newsletters?  Why do I see calm instead of hundreds of vendors scrambling for cover?

Ah, I know why – many (perhaps most) wellness programs are based upon intuition, rather than science.  It seems like it should be a good thing to see a doctor.  It makes sense that nipping an illness in the bud should be better for you, and cheaper.  But neither of these intuitions is borne out by science.

And this may be the most solid science we have yet on annual check-ups.  This latest news (Krogsboll et al, Cochrane Database System Review 10/17/2012) is from a study of 16 different trials conducted by two independent authors.  This is called a meta-analysis, for you techie types; think of it as a study of studies.  It is considered the gold standard for analyzing data.  A total of 182,880 people were studied.

Here are the authors’ conclusions:

  • General health checks did not reduce illness or death.
  • Deaths from heart disease or cancer were not affected by getting a general health check.
  • “ . . . [G]eneral health checks are unlikely to be beneficial.”

So, why do wellness programs prefer emotion to evidence?  It may have something to do with how the human brain is wired.  Humans prefer stories to numbers.  When someone says there are thousands of children starving, it has less impact than someone showing you a picture of Miguel who has not had food since last Tuesday.

Surely the people who want to reduce health costs would blow past the fuzzy stuff.  Yet, even cost-cutters can be swayed by emotion or by scientific-sounding fluff.  A scientist could point to lower overall deaths from heart attacks, and imply that preventive care deserves the credit.

It will be a great day when we openly admit that emotion-based programs will not save money, save lives, or even improve health.  Until then, I will take heart in seeing these studies reported in the news – even if it is not in the headlines.

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