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Bad Medicine: Doctor Appointments You Should Skip

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No More Yearly Checkups

You know the annual physical drill: Blood pressure -- check! Eyes, ears, throat -- check! Blood test (ouch) -- check! But the surprising truth is that "many of these tests don't help promote health or prevent disease," says Miriam Alexander, MD, the director of the general preventive medicine residency program at the Johns Hopkins Bloomberg School of Public Health in Baltimore. "They're just what we've always done."

In fact, a research review concluded that routine medical tests failed to reduce rates of disease, hospitalization, or death. What they can lead to, however, is further testing. "When you run tests, you raise the risk of false positives. That means more tests or trips to a specialist even though there was no reason to run the test in the first place," Dr. Alexander says.

That's not to say you should ditch your doc altogether. It's important to have a physician for when you get sick, and there are certain screenings and vaccinations that you do need over the years. So some experts are calling for a "periodic well visit" instead of an annual checkup. Your doc would focus on preventive behaviors like eating right and exercising and on helping you eliminate disease risk factors such as smoking and weight gain. The two of you would discuss your family's medical history and which tests you truly need to check for heart disease, diabetes and various cancers. Patients with particular risk factors would see a doctor more regularly.

The bottom line: Until periodic well visits become the norm, experts say that if you do opt to get physicals, you may not need to go every year.

So Long, Stirrups!

Imagine going to your gyno and not spending the appointment staring at the ceiling with your knees in the air. "Until the Pap test was introduced, a woman didn't go to the ob-gyn unless she was pregnant or had symptoms like pain or bleeding," Dr. Westhoff says. When the Pap became standard in the late 1940s, so did the yearly gyno exam. But in 2012, based on new research, the American College of Obstetricians and Gynecologists (ACOG) told its members to dial back on the Pap test and give it every three years; for women 30 and older who combine it with a test for human papillomavirus (HPV), the recommendation is every five years.

The reason: Although the Pap can be a lifesaver, there is no benefit to screening on an annual basis, because cervical cancer is slow growing. "If you do Pap smears frequently, you'll get some results that are 'not normal' but aren't cancer," Dr. Alexander says. "Patients might then be ordered to have uncomfortable additional testing, which causes anxiety and can, in rare cases, lead to severe complications."

As for annual pelvic exams, women simply don't need them, research has found. The exams are not necessary to screen for ovarian and uterine cancers or sexually transmitted infections, and they don't need to be done before a woman starts taking oral contraceptives. "Gradually, more and more ob-gyns are realizing that the pelvic exam doesn't have to be done so frequently," Dr. Westhoff says.

The bottom line: The ACOG still recommends an annual gyno visit, but unless you have a medical problem or new symptoms, you probably don't need a pelvic exam between Pap tests, Dr. Westhoff says.

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bahh24 wrote:

That article is reflecting our healthcare screening is protecting us Obama is making screening a healthcare disaster very bad decision you make on individual health care .

8/23/2014 05:13:52 PM Report Abuse
dr.sharp wrote:

I am very disappointed in this story. All I can say is as a healthcare professional "covering your butt" is not something to be ashamed of. It's how you ensure the longevity of your career, care for your patients and put food on the table for your family. Someone who maintains such a laissez faire view of preventative medicine obviously holds no high-stakes roles in the medical community. Stick to writing articles.

3/31/2014 08:11:36 AM Report Abuse
paris10gal wrote:

To any woman who stops having mammograms because they are painful...what's really painful is surgery, radiation and chemotherapy! Ladies, please keep having those mammograms because they are true life savers. Tenderness for a day or two is nothing compared to having cancer treatments. Thank God for mammograms!

3/30/2014 10:09:17 PM Report Abuse
mjsel74 wrote:

What if it were your Mother, Sister, Wife, or Girl Friend that died because they couldn┐t have this type of cancer testing? There needs to be more responsible educating to help woman when they have to go through situations like this. Your website could go a long way in helping to reach out and educate woman and men about cancer and provide resources to help them when they have a cancer scare or are going through cancer treatment rather than giving them an excuse to not take care of their health.

3/30/2014 11:20:03 AM Report Abuse
junkbuster87555 wrote:

Good point. Not much written about docs overdoing it with testing. How much time do we all really need to spend in doctors' offices?What are some of these things basedon besides making some extra money for the practice? I have heard some interesting rebuttal from doctors that have really made no difference years later. Then when I actually wanted to fill a prescription for the one thing that would make me feel better, our United Health Care HMO would not allow the prescription to be filled!

3/30/2014 06:15:01 AM Report Abuse

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