# Regular health check ups: Yay or Nay **URL:** \ **Category:** Great Debates\ **Created:** [March 14, 2016, 9:34pm UTC](https://boards.straightdope.com/t/regular-health-check-ups-yay-or-nay/749013 "2016-03-14T21:34:48Z")\ **Posts on this page:** 20\ **Page:** 2
**Author:** ![WhyNot](https://avatars.discourse-cdn.com/v4/letter/w/c77e96/32.png) [@WhyNot](https://boards.straightdope.com/u/WhyNot)\ **Post date:** [March 15, 2016, 1:49pm UTC](https://boards.straightdope.com/t/regular-health-check-ups-yay-or-nay/749013/21 "2016-03-15T13:49:17Z")
> [@Flyer](#): > > There’s another issue besides what other posters have mentioned. Some of the guidelines really aren’t worth much. > > To take your cholesterol example–most people don’t know it, but just because your levels are “normal” doesn’t necessarily mean a whole lot. > [Patient Education – Boston Heart](http://www.bostonheartdiagnostics.com/patients_understanding.php) > [Newsroom | UCLA](http://newsroom.ucla.edu/releases/majority-of-hospitalized-heart-75668) That’s restricting it to only LDL, though. Who does that these days? Today it’s HDL and LDL and triglycerides and VLDL and ratios thereof. I am suspicious of the pushing to lower cholesterol in those patients with zero other risk factors for cardiovascular disease…I’m just hard pressed to recall anyone I’ve ever met with zero other risk factors for cardiovascular disease… ---
**Author:** ![DrCube](https://avatars.discourse-cdn.com/v4/letter/d/a3d4f5/32.png) [@DrCube](https://boards.straightdope.com/u/DrCube)\ **Post date:** [March 15, 2016, 7:46pm UTC](https://boards.straightdope.com/t/regular-health-check-ups-yay-or-nay/749013/22 "2016-03-15T19:46:23Z")
Women often don’t get the privilege, because their doctors won’t give them a prescription for birth control if they don’t get an annual checkup. I have this problem too, because my doctor only gives me a year’s worth of refills for my GERD medication. So it’s a nice idea, but if you require daily meds, your doctor will extort a yearly visit out of you regardless of your feelings on the matter. ---
**Author:** ![spamforbrains](https://avatars.discourse-cdn.com/v4/letter/s/e274bd/32.png) [@spamforbrains](https://boards.straightdope.com/u/spamforbrains)\ **Post date:** [March 15, 2016, 8:16pm UTC](https://boards.straightdope.com/t/regular-health-check-ups-yay-or-nay/749013/23 "2016-03-15T20:16:51Z")
> [@](#): > > Women often don’t get the privilege, because their doctors won’t give them a prescription for birth control if they don’t get an annual checkup. I have this problem too, because my doctor only gives me a year’s worth of refills for my GERD medication. So it’s a nice idea, but if you require daily meds, your doctor will extort a yearly visit out of you regardless of your feelings on the matter. yeah, this is a pet peeve of mine. Particularly the birth control, because there is no medical reason for a checkup before prescribing it. In fact, there is no medical reason why birth control pills aren’t available OTC. Docs want money and control. It has nothing to do with practicing good medicine. ---
**Author:** ![Anaamika](https://avatars.discourse-cdn.com/v4/letter/a/5f9b8f/32.png) [@Anaamika](https://boards.straightdope.com/u/Anaamika)\ **Post date:** [March 15, 2016, 8:26pm UTC](https://boards.straightdope.com/t/regular-health-check-ups-yay-or-nay/749013/24 "2016-03-15T20:26:52Z")
And cynically at its base I’m sure it has something to do with religion. Those slutty women, they shouldn’t be able to buy birth control OTC. :rolleyes: Since I got the Essure treatment (sterility) at least that is off my list. I figure I get spot-checked pretty often. I get my pelvic exam yearly although I wonder why I have to. I get my teeth cleaned every six months. I went to the dermatologist last year, they told me I should come in every year. HA! That ain’t happenin, sister. I went to get a mole removed, they removed it, checked all my other moles, and said there was nothing concerning. I’ll be back in five years. Maybe. I got my baseline mammogram done last year and it was clear as a bell. So I also wonder why I have to go every year. Plus I’m getting allergy shots so I see my allergy doc every six months…also a waste of time and money. It is less than a 20 minute appointment, he makes sure everything’s on track, I go back to getting the shots. But I can’t get the shots if I don’t go, and the shots are really helping. A routine checkup? Maybe this year, I did get an invite to the doctor’s office. ---
**Author:** ![WhyNot](https://avatars.discourse-cdn.com/v4/letter/w/c77e96/32.png) [@WhyNot](https://boards.straightdope.com/u/WhyNot)\ **Post date:** [March 15, 2016, 8:27pm UTC](https://boards.straightdope.com/t/regular-health-check-ups-yay-or-nay/749013/25 "2016-03-15T20:27:36Z")
What I don’t understand is why my health insurance company keeps nagging me to see my PCP. Is this part of the “preventative care” mandate, that they send me letters telling me to see my doctor? Shouldn’t they be glad I’m paying them premiums every month and not submitting claims? ---
**Author:** ![DrCube](https://avatars.discourse-cdn.com/v4/letter/d/a3d4f5/32.png) [@DrCube](https://boards.straightdope.com/u/DrCube)\ **Post date:** [March 15, 2016, 8:27pm UTC](https://boards.straightdope.com/t/regular-health-check-ups-yay-or-nay/749013/26 "2016-03-15T20:27:37Z")
> [@spamforbrains](#): > > Docs want money and control. It has nothing to do with practicing good medicine. I feel the same way about prescriptions in general. If I want to take horse chemotherapy for shits and giggles that should be between me and my God. I shouldn’t have to ask an expert for permission to buy or consume anything I want. Prescriptions should be expert _advice_ I can voluntarily take or leave, not mandatory _permission_. This is supposed to be a free country. But I fully recognize that horse left the sailboat about a century ago. Even under our current regime, I think birth control should be available over the counter. ---
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [March 15, 2016, 8:34pm UTC](https://boards.straightdope.com/t/regular-health-check-ups-yay-or-nay/749013/27 "2016-03-15T20:34:46Z")
> [@spamforbrains](#): > > In fact, there is no medical reason why birth control pills aren’t available OTC. Docs want money and control. It has nothing to do with practicing good medicine. Actually… there are some medical contra-indications for hormonal birth control. Certain women are at high risk of complications and should not use them so yes, it does make some sense for doctors to act as gatekeepers. _Most_ women can use them safely, but some can’t. Regrettably, when they first came on the market this wasn’t as well known. My family lost a couple women to lethal side effects. We get screened for that now, so it hasn’t happened in a long time, but again, that’s sort of the point - you need to know who’s at high risk. At least the first time you use them. But there’s no way to guarantee that people will be seen at least once, before that first time, without making them prescription-only. ---
**Author:** ![Claverhouse](https://avatars.discourse-cdn.com/v4/letter/c/13edae/32.png) [@Claverhouse](https://boards.straightdope.com/u/Claverhouse)\ **Post date:** [March 15, 2016, 8:53pm UTC](https://boards.straightdope.com/t/regular-health-check-ups-yay-or-nay/749013/28 "2016-03-15T20:53:34Z")
[QUOTE=DrCube] Women often don’t get the privilege, because their doctors won’t give them a prescription for birth control if they don’t get an annual checkup. [/QUOTE] Really ? In Britain the [**NHS**](http://www.nhs.uk/Conditions/contraception-guide/Pages/contraception.aspx) will give out before and after contraceptives, 15 types, to anyone who turns up, come one, come all, regardless of national status or age, from\*\*: contraception clinics Brook centres some pharmacies (find pharmacies near you) most sexual health clinics, also known as genitourinary medicine (GUM) clinics most NHS walk-in centres (England only) most NHS minor injuries units (MIUs) most GP surgeries (find GPs near you) some hospital accident and emergency (A&E) departments **mostly free ( certainly to all people living here ) but some will charge tourists or from private doctor practices or walk-in clinics. It does seem wrong to charge money for what is essentially a health matter. This is not especially ideal though**. \*\*Interestingly, as part of **President Clinton’s Welfare Reform** , America did introduce [**Abstinence Programs**](http://www.bbc.co.uk/ethics/contraception/abstinence_1.shtmlhttp://www.bbc.co.uk/ethics/contraception/abstinence_1.shtml) in 1997: those are unknown in Britain and most of the world, and offer the same uses as contraception. Not only the teenagers and others waiting for marriage need pledge themselves to virginity or refraining from sexual acts — since even the touch of a hand can send one Hellwards Bound if unsanctioned — but all people. Mr. Obama recently reduced federal funding for these Clintonesque initiatives: the presidents may go to different sects. ---
**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\ **Post date:** [March 15, 2016, 9:09pm UTC](https://boards.straightdope.com/t/regular-health-check-ups-yay-or-nay/749013/29 "2016-03-15T21:09:57Z")
It’s worth noting that most health insurance plans - including high deductible plans - pay in full for an annual physical. So at least it’s free (to you). ---
**Author:** ![spamforbrains](https://avatars.discourse-cdn.com/v4/letter/s/e274bd/32.png) [@spamforbrains](https://boards.straightdope.com/u/spamforbrains)\ **Post date:** [March 15, 2016, 9:16pm UTC](https://boards.straightdope.com/t/regular-health-check-ups-yay-or-nay/749013/30 "2016-03-15T21:16:28Z")
> [@](#): > > Most women can use them safely, but some can’t. they are safer than aspirin, and easier to use than aspirin. Aspirin is our benchmark for what should be OTC or not. ---
**Author:** ![WhyNot](https://avatars.discourse-cdn.com/v4/letter/w/c77e96/32.png) [@WhyNot](https://boards.straightdope.com/u/WhyNot)\ **Post date:** [March 15, 2016, 10:50pm UTC](https://boards.straightdope.com/t/regular-health-check-ups-yay-or-nay/749013/31 "2016-03-15T22:50:04Z")
> [@Broomstick](#): > > Actually… there are some medical contra-indications for hormonal birth control. Certain women are at high risk of complications and should not use them so yes, it does make some sense for doctors to act as gatekeepers. _Most_ women can use them safely, but some can’t. > > Regrettably, when they first came on the market this wasn’t as well known. My family lost a couple women to lethal side effects. We get screened for that now, so it hasn’t happened in a long time, but again, that’s sort of the point - you need to know who’s at high risk. At least the first time you use them. But there’s no way to guarantee that people will be seen at least once, before that first time, without making them prescription-only. No, sorry. There are fewer contraindications for BCPs than for NSAIDS. What contraindications there are can be screened for by women themselves, as several studies have shown. Not to mention over 100 countries where BCPs are OTC and women aren’t dying in droves. Pills today bear little relation to the Pill when it first came out. The doses are much lower, and along with that, so are the risks and side effects. The [American College of Obstetricians and Gynecologists](http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Gynecologic-Practice/Over-the-Counter-Access-to-Oral-Contraceptives), [The American Medical Association](http://www.ama-assn.org/ssl3/ecomm/PolicyFinderForm.pl?site=www.ama-assn.org&uri=%2fresources%2fhtml%2fPolicyFinder%2fpolicyfiles%2fDIR%2fD-75.995.HTM), and [The American Academy of Family Physicians](http://www.aafp.org/about/policies/all/otc-oral-contraceptives.html) all support making BCPs OTC on medical grounds. Birth control manufacturers do NOT support making them OTC. Right now, they can charge insurance companies many dollars a month to pay for them. Switch to OTC and it’s likely they’d need to reduce the price to make them competitive. The best argument against making BCPs OTC is financial: if they’re made OTC, we’ve got to either give up on insurance paying for them, or make another regulation so that insurance pays for them OTC, which is highly unusual for an OTC med. So making them OTC may actually price poor women out of being able to use them. ---
**Author:** ![Leaper](https://avatars.discourse-cdn.com/v4/letter/l/4bbf92/32.png) [@Leaper](https://boards.straightdope.com/u/Leaper)\ **Post date:** [March 15, 2016, 11:05pm UTC](https://boards.straightdope.com/t/regular-health-check-ups-yay-or-nay/749013/32 "2016-03-15T23:05:13Z")
> [@DrCube](#): > > I feel the same way about prescriptions in general. If I want to take horse chemotherapy for shits and giggles that should be between me and my God. I shouldn’t have to ask an expert for permission to buy or consume anything I want. Except antibiotics, right? ETA: Apparent irony in username in thread. 🙂 ---
**Author:** ![usedtobe](https://avatars.discourse-cdn.com/v4/letter/u/ec9cab/32.png) [@usedtobe](https://boards.straightdope.com/u/usedtobe)\ **Post date:** [March 15, 2016, 11:09pm UTC](https://boards.straightdope.com/t/regular-health-check-ups-yay-or-nay/749013/33 "2016-03-15T23:09:58Z")
> [@WhyNot](#): > > What I don’t understand is why my health insurance company keeps nagging me to see my PCP. Is this part of the “preventative care” mandate, that they send me letters telling me to see my doctor? Shouldn’t they be glad I’m paying them premiums every month and not submitting claims? Because: For the 10,987,317th time: The SOONER the problem is found, the MUCH easier (read: cheaper AND less painful) it is to fix. Take me, for the 213th time: I was given an ultrasound in 2008, based on visits to doc for other reasons. That ultrasound detected kidney disease. At that point, certain changes to diet and OTC drugs controlled it. In 2015, I developed my first “This is something to see a Doc about” symptom of kidney disease. At that point, had I not made the changes in 2008, I could already be on the $2500/week drug used for advanced kidney disease (the Lance Armstrong stuff). In the case of cancers, waiting until that “annoying tic” becomes “oh shit, better see a doc” can make a huge difference in prognoses. Cancer of the Pancreas is so deadly because it has to get really huge (and fatal) before most people get any symptom at all. ---
**Author:** ![spamforbrains](https://avatars.discourse-cdn.com/v4/letter/s/e274bd/32.png) [@spamforbrains](https://boards.straightdope.com/u/spamforbrains)\ **Post date:** [March 15, 2016, 11:18pm UTC](https://boards.straightdope.com/t/regular-health-check-ups-yay-or-nay/749013/34 "2016-03-15T23:18:38Z")
> [@](#): > > For the 10,987,317th time: > > The SOONER the problem is found, the MUCH easier (read: cheaper AND less painful) it is to fix. Not true. For cars, maybe, but not for mammals. ---
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [March 15, 2016, 11:49pm UTC](https://boards.straightdope.com/t/regular-health-check-ups-yay-or-nay/749013/35 "2016-03-15T23:49:16Z")
> [@WhyNot](#): > > No, sorry. There are fewer contraindications for BCPs than for NSAIDS. What contraindications there are can be screened for by women themselves, as several studies have shown. Frankly, I don’t trust the average American to do that in a competent manner. There’s already too much woo belief out there. People _think_ they know more about medicine than they actually do, and they _think_ they know how to do proper internet research, but they often don’t. But hey, I can agree to disagree on this. If they do go OTC it’s not something I’m going to picket or anything. ---
**Author:** ![DrCube](https://avatars.discourse-cdn.com/v4/letter/d/a3d4f5/32.png) [@DrCube](https://boards.straightdope.com/u/DrCube)\ **Post date:** [March 16, 2016, 12:08am UTC](https://boards.straightdope.com/t/regular-health-check-ups-yay-or-nay/749013/36 "2016-03-16T00:08:55Z")
> [@Leaper](#): > > Except antibiotics, right? > > ETA: Apparent irony in username in thread. 🙂 Absolutely. I can get behind restrictions in the case of legitimate shortages, too. People who are actually sick with the diseases those drugs treat should get dibs. But just because I might hurt myself or get high or have a little more sex or use it in an unapproved manner? That shouldn’t be anybody else’s decision except mine. If this fantasy situation were to occur, it goes without saying that doctors, schools, the FDA, and other government agencies need to educate people and make the information about all drugs and their effects conveniently available. And not “this is your brain on drugs” propaganda either but real, honest, trustworthy information. Needless to say, I’m not a real doctor, nor do I play one on TV. 😉 ---
**Author:** ![MLS](https://avatars.discourse-cdn.com/v4/letter/m/919ad9/32.png) [@MLS](https://boards.straightdope.com/u/MLS)\ **Post date:** [March 16, 2016, 12:12am UTC](https://boards.straightdope.com/t/regular-health-check-ups-yay-or-nay/749013/37 "2016-03-16T00:12:04Z")
I’m not a doctor. However, I had a rather large but completely symptomless growth on my ovary found only because I went for regular annual checkups. It had grown to grapefruit size in under a year. It was removed and found to be a “borderline lesion” which I understand to be a very very early stage cancer. I took some chemo prophylactically for about a year in case cells had spread. My doctor said if might have eventually turned truly malignant. I was in my 30s at the time; I’m now almost 70. My MIL, on the other hand went to a convenient but not very sensible doctor who wanted her, a 90+ year old widow, to get a pap test. He did not, however, recommend a colonoscopy. Guess what she died of. Yep, colon cancer. She had been otherwise healthy and would probably have survived to see her great-grandchildren if she’d had that detected as polyps and not stage 4 cancer. ETA: Antibiotics should definitely only be used if (and as) prescribed. Far too many people have bad habits of wanting antibiotics for viral infections, not finishing the full course of treatment, and in other ways not following genuine medical direction. It would be even worse if people could get OTC penicillin. We have enough antibiotic-resistant germs already. ---
**Author:** ![usedtobe](https://avatars.discourse-cdn.com/v4/letter/u/ec9cab/32.png) [@usedtobe](https://boards.straightdope.com/u/usedtobe)\ **Post date:** [March 16, 2016, 12:53am UTC](https://boards.straightdope.com/t/regular-health-check-ups-yay-or-nay/749013/38 "2016-03-16T00:53:52Z")
I have mixed feeling on antibiotics. I stock some common ones. No, I am not telling how to get them. But: For those traveling to China, all kinds of inoculations are/were advised. Why? Because, in China, antibiotics ARE OTC - and they have some really impressive antibiotic-resistant bugs as a result. This is why antibiotics are by 'script only in the West. ---
**Author:** ![WhyNot](https://avatars.discourse-cdn.com/v4/letter/w/c77e96/32.png) [@WhyNot](https://boards.straightdope.com/u/WhyNot)\ **Post date:** [March 16, 2016, 1:05am UTC](https://boards.straightdope.com/t/regular-health-check-ups-yay-or-nay/749013/39 "2016-03-16T01:05:56Z")
> [@usedtobe](#): > > Because: > > For the 10,987,317th time: > > The SOONER the problem is found, the MUCH easier (read: cheaper AND less painful) it is to fix. > > Take me, for the 213th time: Okay, let’s play dueling anecdotes then, if that’s what you want instead of actual data. My grandfather dutifully went in for an annual PSA and prostate exam and was diagnosed with prostate cancer. That lead to two years of torturing him to death treating the cancer. The cancer was one of the slow growing kind that was incredibly unlikely to kill him before he died of something else. My aunt went in for a routine annual Gyn exam with mammogram referral and they found a lump. They spent tens of thousands of dollars on painful testing and biopsies and surgeries and it turned out to be a benign hyperplasia. Not cancer. Not life or health threatening, but ruined her quality of life for months, and has led to an anxiety disorder and hypochondria long term. For every one of you, there are hundreds of them. Of course I’m glad that they caught your problem and saved your life - but **your problem was not one that would have been caught with a routine annual exam anyway**. They don’t do ultrasounds as part of routine annual exams. So you’re arguing for something that wouldn’t have helped you anyway, and does harm a great many people. If you’re arguing for annual exams, then you’re arguing for a vitals check: blood pressure, heart rate, respiratory rate and temperature - all of which vary wildly in both healthy and unhealthy people, so one reading tells you nothing about a person’s health status. The doctor may spend some time listening to your heartbeat and lungs, and perhaps a reflex check and look at your eyes and ears. I’ve never received so much as an abdominal palpation during an annual. There are no routine blood tests for an annual exam, although some doctors may order a CBC, BMP or urinalysis - NONE of which are very useful tests if you’re having no symptoms. There’s no ultrasound or x-rays or MRIs. > [@](#): > > For healthy adults between the ages of 18 and 65, The American Academy of Family Physicians (AAFP) recommends only these components of the traditional physical exam: > > For men, a blood pressure measurement. > For women, a blood pressure measurement and a periodic Pap smear. [Re-thinking the Annual Physical | Science-Based Medicine](https://www.sciencebasedmedicine.org/re-thinking-the-annual-physical/) Worse (as also pointed out in that article), annual exams give people a false sense of reassurance. They ignore that new onset chest pain because “I just saw the doctor last month, and he said I was fine!” So they actually delay treatment \*longer \*when they do become symptomatic. And that’s the worst time. That’s when you \*should \*be seeing your doctor regularly. ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [March 16, 2016, 2:02am UTC](https://boards.straightdope.com/t/regular-health-check-ups-yay-or-nay/749013/40 "2016-03-16T02:02:05Z")
> [@usedtobe](#): > > Because: > > For the 10,987,317th time: > > The SOONER the problem is found, the MUCH easier (read: cheaper AND less painful) it is to fix. It isn’t that simple. It would be nice if it were, but it isn’t. Here is another likely scenario: A person is diagnosed as having a risk factor or disease that would never happen or cause symptoms. Doctors insist on treating it anyway. The patient now has to deal with the side effects of therapy, but will not receive any benefit because those risk factors never would’ve translated into a symptomatic disease. Its not easy. Studies on several forms of diagnostics or primary prevention are showing that medical therapy does more damage than doing nothing. A very large % of elderly people, upon autopsy, are found to have thyroid cancer, prostate cancer, or other conditions which did not contribute to their deaths or cause symptoms. Some doctors insist on treating these conditions but the patients never would’ve died or had symptoms from these cancers. However the treatments have side effects. [Previous page](https://boards.straightdope.com/t/regular-health-check-ups-yay-or-nay/749013.md?page=1) [Next page](https://boards.straightdope.com/t/regular-health-check-ups-yay-or-nay/749013.md?page=3)