Annual Physicals

Roughly one-third of U.S. adults visit receive an annual in a given year, and that trend appears to continue unabated each year. Surveys demonstrate that the majority of both patients and physicians are proponents of the annual physical. In 2011, Medicare even introduced a form of the annual physical as a covered benefit. However, several taskforces and professional societies have reviewed the evidence on the annual physical and called for abandoning it for some or all patients.

One of the quandaries in assessing the role of the annual physical is that its content is poorly defined. Historically, it can include history taking, screening questions for undetected illness or risk factors such as smoking, counseling to address those risk factors, a full physical exam, ordering of recommended preventive services, and routine testing such as complete blood counts. The variation in the content of the annual physical is reflected it in its various names, including the annual preventive exam, periodic health examination, annual check-up, multiphasic exam, and routine physical. The Medicare form of this visit is called the Annual Wellness Visit.

In several studies, we have analyzed the patients who receive an annual physical, the geographic variation in its use, and how its content varies. In several perspective pieces, I have laid out the concerns with the current form of the annual physical and theorized how it might be improved.

  • Ganguli I, Souza J, McWilliams JM, Mehrotra A. Practices Caring For The Underserved Are Less Likely To Adopt Medicare's Annual Wellness Visit. Health Aff (Millwood). 2018;37(2):283-291. PMCID: PMC6080307.
  • Ganguli I, McWilliams JM, Souza J, Mehrotra  A. National trends in use of the U.S. Medicare Annual Wellness Visit, 2011-2014. JAMA, 2017
  • Reynolds EE, Heffernan J, Mehrotra A, Libman H. Should Patients Have Periodic Health Examinations?: Grand Rounds Discussion From Beth Israel Deaconess Medical Center. Annals of Internal Medicine. 2016 Feb 2;164(3):176-83.
  • Mehrotra A, Prochazka A. Improving Value in Health Care – Against the Annual Physical, NEJM. 2015 Oct 15;373(16):1485-7.
  • Mehrotra A, Zaslavsky AM, Ayanian JZ. Preventive health examinations and preventive gynecological examinations in the United States. Archives of Internal Medicine. 2007;167(17):1876-83.