In January 2015, University of Pennsylvania oncologist Ezekiel Emanuel authored a much talked-about editorial in the New York Times questioning the value of annual physicals. Citing research from the Cochrane Collaboration of medical researchers, Emanuel argued that people who missed their routine check-ups suffered no higher a mortality rate than those who dutifully kept their appointments.
For people already prone to skipping exams, Emanuel’s words might have been an affirmation. And while it’s true submitting to a physical may not necessarily stave off death—an unfortunate consequence of being human—there are reasons beyond sterile statistics to make and keep those dates. “Quality of life is a different metric to measure,” says Sharon Bergquist, MD, a primary care provider with Emory Healthcare in Atlanta, Georgia. “It’s important to develop and keep a relationship with a physician because there are benefits not related to mortality. There are levels to feeling well.”
Here’s a look at some of the key reasons people put off or cancel physicals, with Bergquist explaining why it’s not such a good idea.
1. “I feel fine.”
Walking into a physician’s office when you’re full of energy and haven’t even had so much as a sniffle in years can seem like a waste of time and money. But your well-being isn’t always tied into your ability to make self-assessments. “When a person feels well, going to a doctor isn’t going to be a high priority,” Bergquist says. “But many chronic diseases don’t have symptoms, so waiting until you develop some isn’t a good guide.”
Things like high blood pressure, high blood sugar, and other markers for serious outcomes like heart attack and stroke don’t “feel” like anything at first, which is why evaluation by your doctor is critical.
2. “I’m overweight.”
Many of us tend to set personal goals—possibly motivated by a previous doctor’s visit—to lose weight or make other lifestyle changes so we can present a discernible difference in our health attitudes. One study even found that 45 percent of women respondents put off a physical because they were self-conscious about their weight.
“If people have certain conditions we’ve been watching, they might have a set goal in mind,” Bergquist says. “And if they don’t make it, they’ll dread coming back. They want to give themselves more time to lose that 5 pounds. In the meantime, their underlying condition could be getting worse.”
What these patients miss is that their physician will be able to give them the tools they need to reach their goals. “If they don’t know what kind of changes to make to their diet or elsewhere, we can help.”
3. “I don’t want a lecture.”
If your physician has told you to lose weight, cease smoking, or reduce alcohol consumption and you’ve done little to address it, you might be apprehensive about their reaction. If you fear being scolded, Bergquist says it might be time to consider another provider. “We’re here to partner with patients, not frown or make disappointed remarks,” she says. If a doctor makes you feel like you’re getting graded on a test paper, he or she probably isn’t the one for you.
4. “I just saw a specialist.”
For people with medical issues deserving of attention from a specialist, they may feel as though getting their blood pressure or weight quickly checked by a nurse is a proper substitute for a check-up. Why go see your primary when you just got out of an exam gown two weeks ago?
“That’s a pretty common scenario,” Bergquist says. “But most specialists focus on one very specific part of the body and other parts of comprehensive care don’t get addressed. You can get a heart evaluation and they can completely miss pre-diabetic symptoms. It’s just beyond the scope of what they’re looking for.”
5. “I see too many doctors already.”
All the more reason to see one more. “Sometimes specialists will make recommendations that can become very hard to juggle,” Bergquist says. “Patients who have arthritis might take a non-steroidal anti-inflammatory, but then your kidney doctor will say, ‘Never take this.’ You’re caught in the middle. Your physician can help prioritize recommendations and reconcile drug interactions.”
6. “I’m afraid of a bad diagnosis.”
The media—and even our own social and family circles—are filled with stories about people who went in for routine screenings and discovered a serious condition that warranted treatment. The butterflies that come before test results can be stressful, and one way to avoid them is to simply not subject yourself to an exam. But sticking your head in the sand isn’t going to alleviate anything. “I tell people that no matter what we may find, it’s always better to catch it early,” Bergquist says. Putting up with a little anxiety could save you a considerable amount of grief in the future.
7. “I don’t want a prostate exam.” // “I don’t want a mammogram.”
Physicals can often lead to preventative screening tests like mammograms, prostate check-ups, or colonoscopies. In some instances, the tests can provoke discomfort, and patients feel equally uneasy rejecting the doctor’s advice. But it’s helpful to keep in mind that physicians make recommendations, not demands. “It’s always a patient’s choice of what screening tests to get,” Bergquist says. “As long as you’re making a decision based on all the right information, you can make that decision for yourself. Some view the discomfort as greater than the benefit of the test. We just want you to make an educated decision of the pros and cons.”
8. “I’m too young for anything to be wrong.”
While it’s true age has a way of opening doors for chronic ailments, people under 40 shouldn’t consider themselves bulletproof. “The risk for disease is less, but it’s not zero,” Bergquist says. “I’ve seen tragic cases of very young people diagnosed with the worst-case scenarios of heart disease and cancer.” Skin cancer, cervical cancer, and testicular cancer can strike anyone at any age, but early detection can almost always provide more promising outcomes.
There are undoubtedly other justifications for skipping your annual check-up, but most of them boil down to feeling inconvenienced or that it’s a waste of time. Instead, Bergquist suggests changing your perception of a physical from a chore to a motivator. “Having an objective sense of where you are in terms of your health can help you with your goals. Seeing numbers has an impact. It can lead you on a new path.”