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Article
April 24, 1987

Preventive Services in Clinical Practice: Designing the Periodic Health Examination

Author Affiliations

From the US Preventive Services Task Force, Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Washington, DC (Dr Lawrence [chairman] and Dr Mickalide [staff coordinator]); the Cambridge Hospital, Cambridge, Mass (Dr Lawrence); Harvard Medical School, Boston (Dr Lawrence); and The Johns Hopkins University School of Hygiene and Public Health, Baltimore (Dr Mickalide).

From the US Preventive Services Task Force, Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Washington, DC (Dr Lawrence [chairman] and Dr Mickalide [staff coordinator]); the Cambridge Hospital, Cambridge, Mass (Dr Lawrence); Harvard Medical School, Boston (Dr Lawrence); and The Johns Hopkins University School of Hygiene and Public Health, Baltimore (Dr Mickalide).

JAMA. 1987;257(16):2205-2207. doi:10.1001/jama.1987.03390160091034
Abstract

In this issue of The Journal, the US Preventive Services Task Force presents the first in a series of background articles and recommendations for preventive measures that can be incorporated into personal health services.1 The periodic health examination has largely replaced the annual physical examination, and the changing patterns of morbidity and major risk factors call for more integration of clinical preventive services into office visits triggered by acute or chronic symptomatic disease.

In the 1920s, the American Medical Association and the Metropolitan Life Insurance Company first endorsed the annual physical examination as conferring long-term health benefits. Generations of physicians and patients came to regard the annual examination as the keystone of preventive medicine. In the 1970s, increasing cost consciousness, changing expectations of patients, and refined methods for studying the efficacy of diagnostic tests and maneuvers raised serious questions about the value of the annual checkup.2 Clinicians began

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