Health News Review

Just last week we wrote about some of the problems with a TV station’s continuing “Know Your Numbers” campaign.  Now the Star Tribune fuels the “Know Your Numbers” obsession with a front page story in its Variety section today.

There’s nothing wrong with the article’s reminders about blood pressure, total cholesterol, blood sugar, BMI and waist size.  But the article’s last line is simply wrong. It states:

“health experts recommend a physical exam once a year, at which time these very important numbers can be discussed.”

Hmm.  Which experts are those?

A VA Evidence-based Synthesis Program Evidence brief – coincidentally written by doctors in the Star Tribune’s home town – concludes:

“Comprehensive routine physical examinations are not recommended for the asymptomatic adult.”

An article in the American College of Physicians’ magazine was entitled, “Rethinking the value of the annual exam.” It began:

“One constant in medical care is the persistent notion of the value of the annual physical. There’s no strong evidence base for the periodic health exam, as it’s now often called, as a discrete encounter, and no consensus on what it should include.”

And this is not new.  The US Preventive Services Task Force 18 years ago “rejected the traditional emphasis on a standardized annual physical examination as an effective tool for improving the health of patients.”

So who are the experts to which the Star Tribune refers?  This is the kind of broad sweeping statement encouraging the healthy to look harder to prove they are sick that many news media messages thoughtlessly promote.

And we will call them out on it whenever we see it.  It’s inaccurate.  It’s imbalanced.  It’s bad journalism.  And despite what might be the best of intentions, it could result in avoidable harm.

ADDENDUM:

Susan Perry, who writes the Second Opinion column on MinnPost.com, wrote to me about at least one more problem with the Star Tribune story.  She points out that the story says:

“…kiosks at pharmacies and grocery stores make it convenient to get (blood pressure) readings.”

But Perry points to warnings about the accuracy of such kiosk blood pressure monitors – as in this Mayo Clinic expert’s advice when asked whether BP machines in grocery stores and drugstores are accurate:

“Not accurate enough to make health decisions regarding your blood pressure.

The blood pressure machines that you can use free of charge in many grocery stores, drugstores and other locations may have been accurate when first installed. But in order to stay accurate, they must be maintained and recalibrated. Generally, no information is available to the user regarding the care of these devices. As a result, the reading you get has limited value because it may be incorrect.”

So the Star Tribune article made one practice sound as if it were universally endorsed, when it is actually widely questioned.  And it promoted the convenience of another practice about which there are big questions of value and accuracy.  Two for two.  Anyone want to go for three?

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Comments

Gary Thaden posted on September 5, 2013 at 12:27 pm

See 20th comment on StarTribune story:
“Still, health experts recommend a physical exam once a year, at which time these very important numbers can be discussed.” Really? What health experts? In 1995 (18 years ago!), the U. S. Preventative Services Task Force rejected annual physical exams. “The 10-member Task Force rejected the traditional emphasis on a standardized annual physical examination as an effective tool for improving the health of patients. Instead, they emphasized that the content and the frequency of the periodic health exam need to be tailored to the age, health risks and preferences of each patient.” http://odphp.osophs.dhhs.gov/pubs/guidecps/preleas.htm

Trisha Torrey posted on September 9, 2013 at 11:38 am

Another point of view on this subject:

While we may not necessarily need an annual exam for health purposes, that annual trip to the doctor may take on a different sort of importance due to the dearth of primary care options.

I am told by many primary care doctors that as they are getting busier, and their services are more in demand, they are culling their patient panels to those who are “active patients.” One of their culling criteria is those patients who have not visited within the past year.

If someone is healthy, or rarely visits their primary care doctor, then they may find they’ve been dropped from their doctor’s panel. Then, just when they do get sick, and do need care, they won’t be able to find a doctor who will see them.

We can only imagine just how much more difficult that will become once Obamacare kicks in and 32 million new Americans have access to care.

Just another point of view. It may not be about a physical exam, but if that’s the only time you see your doctor, then it may be protectively necessary – even if it’s not medically necessary.

Trisha Torrey
Every Patient’s Advocate
http://www.EveryPatientsAdvocate.com

Laurence Alter posted on September 9, 2013 at 12:42 pm

I believe you have overlooked a few matters, making your conclusion rather *naive*:

1. to quote Dr. Oz (in one of his books): “Men are notoriously negligent” about their health [that is a direct quote, though I don't have the book - or recall the book's title - in front of me at present]. While Dr. Oz has come under some scrutiny and criticism, I would guess the number of patients he has seen and his general observations of (male, in this case) patients can be trusted. If we accept how careless and cavalier the average (male only?) patient is, THEN maybe the customary physical examination is the maximum thought that will go into a person’s health. It might not only uncover physical issues BUT serve as an (unintentional) reminder to not take one’s health for granted.

2. while I have not read the linked sites in blue, above, the above (damning) critique has not stated what is *harmful* about an “asymptomatic” person having regular physical examinations. There is a big, big difference between what is not helpful in life and what is harmful in life (and that is assuming nothing gets learned from a physical examination not “needed” at the time it is performed).

Lastly, people are complacent about what is not in the here-and-now. A physical – even every few years – might shake up some of that complacency.

Respectfully,

Laurence Alter

    Gary Schwitzer posted on September 9, 2013 at 12:47 pm

    Laurence,

    I suggest you read the linked sites, which you said you didn’t read.

    That’s why I linked to them – to provide the kind of background you’re looking for.

    Let me suggest that it might be naive of you to criticize when you haven’t even read the entirety of what I posted and linked to.

    And what is naive about my conclusion? I wrote: “So the Star Tribune article made one practice sound as if it were universally endorsed, when it is actually widely questioned. And it promoted the convenience of another practice about which there are big questions of value and accuracy.”

    Given the evidence I’ve provided, that is 100% accurate. If you think the experts I cited are naive, perhaps you know more than they do. But at least I cited some experts. The Star Tribune did not – making just a vague blanket statement.