PERIODIC MEDICAL EXAMINATION BY DR. ANGELA ESOIMEME MBBS, MPH, FWACGP

The periodic medical examination also known as general medical examination is a common form of preventive measure involving visits to a doctor usually general practioners by well feeling adults on a regular basis. This is generally yearly or less frequently. It is known under several other names, such as the periodic health evaluation, annual physical, comprehensive medical exam, general health check, or preventive health examination.

The term is generally not meant to include visits for the purpose of: A. Newborn checks, B. Pap smears C. Cervical cancer, or D. Regular visits for people with certain chronic medical disorders (for example, diabetes).

The general medical examination generally involves: A. Medical history (brief or complete) B. Physical examination and C. Sometimes laboratory tests. Some more advanced tests include ultrasound and mammography.

Periodic medical examinations aim to detect susceptible workers for whom corrective actions can be taken before they develop overt occupational diseases. For example, a lead worker with a high blood lead level should be suspended from work temporarily to stop further exposure to lead and to receive necessary medical treatment. Meanwhile, safety and health measures at work should be reviewed for necessary remedial actions.

The frequency of periodic medical examinations depends on the nature of the occupational hazards. For most hazardous exposures, however, these examinations are conducted annually.

ADVANTAGES Detection and subsequent prevention of diseases such as high blood pressure, alcohol abuse, smoking, unhealthy diet, obesity and various cancers Early treatment for similar diseases mentioned above They could improve the patient-physician relationship. Decrease patient anxiety.

DISADVANTAGES Time and money could be saved by a more targeted screening – health economics argument. A possible increased anxiety over health risks Medicalisation and over diagnosis could result in harm from unnecessary testing to detect or confirm medical problems.

ARGUMENTS The benefits is poorly supported by scientific evidence in the majority of the population. A 2012 Cochrane review did not find any benefit with respect to the risk of death or poor outcomes related to disease in those who received them. People who undergo yearly medical exams however are more likely to be diagnosed with medical problems. The lack of good evidence contrasts with population surveys which show that the general public is fond of these examinations, especially when they are free of charge. Despite guidelines recommending against routine annual examinations, many family physicians in developed countries still perform them.

RECOMMENDATIONS A fee-for-service healthcare system has been suggested to promote this practice. An alternative would be to tailor the screening interval to the age, sex, medical conditions and risk factors of each patient. This means choosing between a wide variety of tests. For example The American Cancer Society recommends a cancer-related health check-up annually in men and women older than 40, and every three years for those older than 20.

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