Do I need to get a yearly physical during the pandemic if I feel fine?
My doctor is a real stickler for staying on top of yearly exams, regardless of how “youth and healthy” I am. I have seen him twice a year for over a decade, and if I am late in booking my biannual check up, his office calls me constantly until I surrender my Medicaid card. I have always appreciated his obvious dedication to making sure I stay in good health but this year, I felt unsure. It seems scary to go into a medical facility during a pandemic. And do I really need to get a checkup if I feel fine? I asked doctors what young healthy people should know about getting an annual physical during the pandemic.
“It's not always necessary for young, healthy people to have yearly visits,” says Lisa Ravindra, a Chicago-based internal medicine physician. Many large studies have shown that annual visits don't prevent patients from getting sick, she notes. But Ravindra believes the most important part of a yearly visit is discussing preventive care. Basically, getting an exam won’t keep you from getting sick, but the conversations that you have with your doctor about your body and habits could help you stay well.
There are other factors to consider, too, like the impact that having a relationship with your doctor can have on your health. “Familiarity ultimately leads to better care,” Ravindra says. “When I get to know a patient over time, making diagnoses and catching problems becomes easier.”
My doctor, for example, takes note of everything during an exam. During my last visit, he asked me why I had changed my hair color from pink to orange and told me that he was glad to see that I’ve been staying at a stable weight. While my hair color is pretty arbitrary, my doc knows that — for me — staying at a healthy weight is an indicator of my emotional health, and it’s really helpful to have a medical professional who’s keeping tabs on me.
If you have particular medical issues and imbalances, Ravindra says, it is really important to get routine lab work or screenings that will help you and your doctor monitor your state of health. But if you don’t have any health issues of note, you may not need all the things that generally comprise an annual exam.
And this is something you might not have thought of but just going to the doctor when you don’t absolutely need to could add to your stress level. “Sometimes having unwarranted labs done in a healthy person leads to further expensive testing and patient anxiety,” Ravindra says.
Having a regular yearly checkup for someone who is basically healthy sounds like common sense — and the ultimate form of preventative medicine — but this is surprisingly controversial. That's because a physical is a type of screening; in other words, it’s an opportunity to look for illness in people who have no symptoms, says Morton Tavel, an Indiana-based cardiologist and professor at Indiana University School of Medicine. “Screening has a nasty habit of doing more harm than good, especially in the absence of evidence to prove its worth in reducing disease and mortality,” Tavel says. “The potential downsides of screening are that it can worry people unnecessarily, offer false reassurance, or trigger unneeded tests and treatments.”
The idea of getting a yearly checkup is kind of an American thing, Tavel says, and it’s not that well accepted internationally. Regular checkups have only recently been introduced in the UK, and are still only done every five years, he says. In other words, doctors around the world seem pretty skeptical about how often Americans go to the doctor. And it’s not because non-American doctors haven’t done the research. Tavel cites a recent Danish study in which 60,000 Danish people were offered annual checkups every year for five years. But even five years after the checkups ended, there had been no effect on heart attacks or overall death rates.
Basically, if you’re young and healthy, you can probably skip your checkup this year — or better, postpone it for a few months. But both Ravindra and Tavel each stressed that if you have any symptoms or issues, even if they’re seemingly small, you should talk to a doctor, even as a telehealth visit. I stress this advice, especially regarding pelvic exams for people with vaginas. If you can’t book a telehealth visit, just make sure to wear a mask, stay socially distant, and keep washing your hands. Most doctor offices and hospitals are fastidious about COVID-19 safety, so you probably don’t have to worry that you’re walking into a superspreader.