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June 8, 2021

The Routine General Medical Checkup: Valuable Practice or Unnecessary Ritual?

Author Affiliations
  • 1Department of Medicine, University of South Carolina School of Medicine, Columbia
  • 2now with Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado
JAMA. 2021;325(22):2259-2261. doi:10.1001/jama.2021.4922

During the mid-20th century, the routine checkup became an annual ritual among people with access to medical care in the US.1 A complete physical examination and performance of various laboratory tests—neither of which were standardized or tailored specifically to patients’ needs or risk profiles—were assumed to constitute good preventive medical care. However, clinicians and researchers began to question the value of this practice,2-4 and, in 1976, Canada preceded the US in establishing a task force to develop a more logical, evidence-influenced, and cost-effective approach to health promotion and disease prevention.5 In 1979, the Canadian Task Force on the Periodic Health Examination published its initial version of The Periodic Health Examination, arguing that “the routine annual check-up be abandoned in favour of a selective approach that is determined by a person's age and sex.”5 Soon thereafter, the US Preventive Services Task Force (USPSTF) was created and adopted a similar philosophy and model, with strong emphasis on evidence-based practices.6