At what age should you start to have regular check ups with your GP?

March 18, 2007 5:31 AM

At what age should you start to have regular check ups with your GP? And what things do you get checked?

I am 29 and have what you could call robust health. The only health issues I have to contend with are one cold/flu like illness per year...So I haven't been to the doctor in years.

Whenever I have moved in recent years I have registered with the local GP and this entails the nurse taking your blood pressure and a urine sample and that's it.

The last blood test I had was age eleven when they tested my rubella antibody levels to work out if I needed the vaccine or not.

The only other times my blood has been tested is when I give blood.

My gut feeling is that as long as I feel fit and well I don't need to go for regular check-ups at my age.

This is not to say that I would not get changes in my level of well being, energy levels or bodily functions investigated - it just so happens that my body seems to work like a clock work. If it doesn't there is normally a reason like sleep deprevation or poor diet and things go back to normal when I address this reason.

posted by koahiatamadl to health & fitness (26 comments total)

Depends on your family medical history. See, my family has a history of colon problems on both sides, including colon cancer, so about age 30 I'm going to get a camera shoved up my butt every 2 years or so due to my general dislike of colostomy bags.

As it is, I plan on a checkup yearly. I'm 27. Insurance pays for it, so I don't care very much -- a $25 copay is cheap insurance for knowing that I'm generally healthy.
posted by SpecialK at 5:46 AM on March 18, 2007

There is a growing body of evidence that suggests that so-called regular check-ups are not helpful and may even be harmful.
posted by Violet Hour at 5:51 AM on March 18, 2007

I had a physical once a year throughout my childhood, adolescence, and college years, and once every year or two since then. It still strikes me as bizarre that so many people don't.

Yes, it's true that most of the time they find nothing. But they might discover that, for example, you have a heart problem or hypertension (each of those were discovered, at a life-threatening level, in relatives of mine in childhood, and those people are still alive now because of treatment they received).

The truth is that all kinds of things can go wrong with you, whether you take care of yourself or not, and it's best to at least know whether you need to watch out for anything. People who say "Why go to the doctor if you're not sick?" have been lucky enough not to have a life-threatening ailment befall them or anyone they're close to without warning. Yes, sometimes it would have happened anyway. And sometimes it wouldn't. Taking the risk because you think that medicine is a conspiracy to give you unnecessary chemotherapy is ridiculous.

My adult checkups are with an internist, not a GP. I get a batch of blood tests (including cholesterol, for example), and we discuss them. If my insurance didn't pay for such visits, I would pay for them myself.
posted by bingo at 6:33 AM on March 18, 2007

Violet: Not to turn this into a debate, but my Aunt did the study as part of her PhD that Oregon used to justify not having school nurses any longer. I mean, 90% of all visits to the school nurse were with no real health complaint except for a headache. I went to two high schools, one that had a nurse and one that didn't. I think that study was paid for by insurance companies. :-P

I mean, that's how a girl in my freshman year found out she was pregnant, thanks to an, "Oh, by the way, is it normal for ..." to the school nurse.

The kind of analysis done in the article you linked and the study my aunt did completely leaves out the value of "Oh, by the way, is it normal for..." because it can't be quantified. "Oh, BTW" is how my uncle found out that he had a heart problem. He was completely healthy otherwise. Worked out three times a week, went running with the dogs the other four days, 40 years old, healthy diet... Made his yearly checkup appointment ("No medical complaint"), was putting his shirt back on after the doc pronounced him healthy, and he mentioned that his chest had felt funny in a particular spot the last time he'd played racquetball. The doctor got a worried look on his face and hooked him up to the little portable EKG in the office. A year and three surgeries later, he's still alive...
posted by SpecialK at 7:04 AM on March 18, 2007 [1 favorite]

I now consider annual checkups to be preventive medecine. Mind you I didn't start until I was 50. I considered high blood pressure, high cholesterol, out of balance triglycerides etc. to be something for ill people to worry about not fit healthy people like myself.
posted by adamvasco at 7:08 AM on March 18, 2007

I mean, that's how a girl in my freshman year found out she was pregnant, thanks to an, "Oh, by the way, is it normal for ..." to the school nurse.

The kind of analysis done in the article you linked and the study my aunt did completely leaves out the value of "Oh, by the way, is it normal for..." because it can't be quantified. "Oh, BTW" is how my uncle found out that he had a heart problem. He was completely healthy otherwise.

Well, the article isn't saying people shouldn't have a vehicle to ask health professionals questions. I think it's saying that skipping useless tests allows more time for dialog about actual issues between patients and physicians.
posted by Violet Hour at 7:17 AM on March 18, 2007

Under the NHS, there's no such thing as 'annual checkups'. People go to the doctor when they're ill.

The NHS Breast Screening Programme provides free breast screening every three years for all women in the UK aged 50 and over. Up to the age of 50, you have to either pay for mammograms yourself or, if you find a lump, then your GP will refer you for a mammogram on the NHS.

All women from 25 to 64 are invited by the NHS for free cervical screening every three to five years. In the present system, by the time a woman is 65 and has had three consecutive negative smears, she is no longer recalled.

In addition to the NHS which I pay for through my taxes and National Insurance, I also have private health insurance, but this doesn't provide for an annual checkup, unless I pay for it myself. It costs around £300 ($570) for the basic one (weight, blood pressure, basic exam) up to about £1,000 ($1900) for a comprehensive health check.
posted by essexjan at 7:30 AM on March 18, 2007

Just make sure your insurance covers an annual physical. When I was 27 I decided it might be a good idea, after many years without one, to have a physical. I assumed that my insurance (which in many other ways was good) would cover it, so I was surprised to get the bill (I think it was about $300, but I may be remembering wrong, it was a while ago) in the mail a few weeks later. I'm not saying you shouldn't get an exam anyway, but you may want to do some research with your insurance company so you don't get an unexpected surprise.
posted by amro at 7:31 AM on March 18, 2007

I'm 25 and get a full annual physical each year. I agree with the preventative sentiments above; just because I feel and look healthy doesn't mean that routine bloodwork or other tests can't find problems. I'd rather catch problems early than get to them in late stages. Many cancers and such are quite treatable if you find them early enough. I also have used the annual physicals as another form of diagnosis when I get sick: if my doctor has seen me healthy, he can pinpoint the exact problem when I am sick.

Some health insurance plans in the US provide an annual physical as a free benefit, so if you have insurance, you may want to check to see if you have the benefit.
posted by galimatias at 7:35 AM on March 18, 2007

"The truth is that all kinds of things can go wrong with you, whether you take care of yourself or not, and it's best to at least know whether you need to watch out for anything....Taking the risk because you think that medicine is a conspiracy to give you unnecessary chemotherapy is ridiculous"

The risk is you getting ill and not not going for the check-up. In all the above mentioned cases patients knew something was unusual and mentioned this to their doctor who then went to investigate...if it wasn't for the annual check up they might have got in touch a month earlier rather than wait for the check-up they were due to have.

In none of the cases mentioned in the replies did the standard check-ups highlight the problem or anything to watch out for.

The girl did not seek adequate contraceptive advice despite the school nurse! The uncle found out he had a problem because he spoke to the doctor and not because he had the check up - in fact he was pronounced healthy after the check-up!
posted by koahiatamadl at 7:47 AM on March 18, 2007

Sorry, but - what? Are you answering your own question there?
posted by different at 8:17 AM on March 18, 2007

If you haven't had your cholesterol checked in years, you should have it tested so you know the score. If you're female you should have pap smears and exams regularly, and if you're sexually active (especially if you're not monogamous) you should be tested for STDs. Frequency for those things depends on your individual situation.
posted by needs more cowbell at 8:35 AM on March 18, 2007

I went to my GP a few weeks back because I was ill. She took a look at my throat and said, "well, you tonsils are big, but...(looks at chart) that's the size they always are."

That's the value of establishing a baseline. It may not be necessary to get a physical every year, but you at least want somewhere in your record a full description of you in your healthy adult state such that it can be used to filter potential symptoms when you're not healthy.

The reason I still go in every year is that denial can be powerful. It's easy to say "oh, that mole's always looked like that" or "that lump's always been there."
posted by backupjesus at 8:43 AM on March 18, 2007

My gut feeling is that as long as I feel fit and well I don't need to go for regular check-ups at my age.

You are correct. Doctors are for sick people.
posted by Meatbomb at 8:52 AM on March 18, 2007

If you haven't had your cholesterol checked in years, you should have it tested so you know the score.

There's no need to wait to see a doctor to do this. You can do it yourself with a kit from the drugstore. The same goes for blood pressure: you can check it using those free machines ubiquitous at CVS/Kroger/WalMart/etc.
posted by Violet Hour at 8:56 AM on March 18, 2007

I'm not a doctor and don't play one on T.V., but my feeling is that you shouldn't confuse "regular" with "annual." It seems to me that turning 30 is a good time to get a baseline physical. Then you'll have a snapshot of what you look like when you're healthy, which might be useful for comparison purposes if you ever get sick. You can also talk to your doctor about long-term issues for you to keep in mind. There might be some things that aren't on your radar, like your skin cancer risk. I don't think you need to do an annual physical after that: unless you have a problem, you can go back in five years.

On the one hand, annual physicals for healthy people seem like overkill. But on the other, in our society men have a tendency to neglect their health. The goal here, I think, is to find a happy medium.
posted by craichead at 9:23 AM on March 18, 2007

Two paradigms:

Cost/benefit [i.e. evidenced based]: No value for most "physicals" as dolllars spent does not equal lives saved, except a few specific tests.

Individual [my practicing paradigm]: If you are making an effort to avoid an early grave by avoiding excessive risk, i.e. not smoking, not drinking to excess, watching your weight, then it's completely reasonable to seek screening on an individual basis for things like prostate cancer, colon cancer, etc.

Not that those aren't things we check for in all persons at certain ages, but for most people death and morbidity will be from self-induced illness via lifestyle than from something picked up by screening.

Physicals are nothing exotic or special. For most people it's a review of risk behavior, future risk analysis based on current practices and family history, and a good physical exam for skin cancer, breast masses, testicular exams, etc. But every doctor has multiple examples of situations where a person with an otherwise excellent life expectancy was found to have a lurking disaster caught early due to a routine exam. So I don't lose sleep over a few dollars spent on screening for illness in healthy persons when we are spending billions on taking care of people who made themselves sick from their own poor habits.

I hear from patients all the time, "I feel fine" as a response to avoiding a physical. That's exactly how one ought to feel, right up to the point when they don't.
posted by docpops at 9:43 AM on March 18, 2007

There's no need to wait to see a doctor to do this. You can do it yourself with a kit from the drugstore. The same goes for blood pressure: you can check it using those free machines ubiquitous at CVS/Kroger/WalMart/etc.

After which you take the results to your doc when something is off and he repeats it for accuracy.
posted by docpops at 9:45 AM on March 18, 2007

koahiatamadl: In all the above mentioned cases patients knew something was unusual and mentioned this to their doctor who then went to investigate

Uh, no, that is wrong. For example, the above-mentioned cases mentioned by yours truly. One of them is my brother, who had renovascular hypertension. He felt fine; the condition was only discovered because of a routine physical (which then led to a series of appointments with specialists, and multiple hospitalizations and surgeries that eventually saved his life).

It's sounding like you're not asking a question so much as making an argument. Which would be too bad, because, apart from violating the rules of AskMe, the argument you're making is wrong.
posted by bingo at 11:34 AM on March 18, 2007

There's no need to wait to see a doctor to do this. You can do it yourself with a kit from the drugstore.

If you have decent insurance, having a cholesterol test done at a doctor's office/lab will be cheaper, more comfortable, and more accurate. I can't imagine taking a tube of blood from my own inner elbow, and I"m not sure I'd want someone else doing it for me if they're not an experienced phlebotomist. Monitoring your own blood pressure is one thing--heck, I've even been advised to do my own monitoring when I was taking a medicine that could raise BP as a side effect--but drawing more than a pinprick of blood is a different category.
posted by needs more cowbell at 11:39 AM on March 18, 2007

I'm 26, and I do annual physicals, largely to have a relationship with a doctor (that I like) if health issues arise. Plus the preventative exams, pap smears, etc.
If you do ever suddenly feel like crap I've found it saves you a lot of frustration trying to find someone decent & gives you a little more credibility.

Little things can and do pop up (e.g., heart murmur) in a basic physical that are worth checking out (found benign in my case). Dental & eye health are just as important. Actually I think an annual dental cleaning & eye exam pratically come first.

Tests to ask for... if you're suddenly more tired, might want to check for anemia. Your family history is important.
posted by ejaned8 at 2:15 PM on March 18, 2007

I can't imagine taking a tube of blood from my own inner elbow

Me either. That's actually not what you do. With this test you nick your ring finger with one of those medical lance things. It doesn't hurt. As for accuracy, the same labs that process these tests process the tests doctors order.
posted by Violet Hour at 4:41 PM on March 18, 2007

koahiatamadl: "The girl did not seek adequate contraceptive advice despite the school nurse! The uncle found out he had a problem because he spoke to the doctor and not because he had the check up - in fact he was pronounced healthy after the check-up!"

The school nurse was in Texas. They teach abstinence-based education around here; the nurse isn't ALLOWED to tell the girl about contraception. Jesus is supposed to take care of that. :-P

The common thread in both cases was that the people were in the doctor's office for a physical exam, (The girl's physical was pre-sports, my uncle's physical was his annual) and had the opportunity to speak to a doctor about what their bodies have been doing... things that didn't worry them, but it turns out that those things SHOULD have been worrying them. This is another purpose of the annual exam, and it's a lifesaver.
posted by SpecialK at 4:46 PM on March 18, 2007

I guess there is no simple answer and I certainly did not mean to antagonise people by my comment on some of the earlier replies. Thanks all for taking the time to reply.
posted by koahiatamadl at 5:08 PM on March 18, 2007

As essexjan points out, the NHS doesn't pay for routine "check-ups" except in certain cases when the research evidence shows clear benefit, e.g. cervical cancer. However aged 27, when you do go to your GP with an actual symptom, they'll "opportunistically" screen you for certain things including high blood pressure, diabetes, and possibly chlamydia. If you want to pay for regular screening privately, you can do; in fact some kind of Harley St quack will probably happily accept your money for a whole body CT. You should be aware though that there might be risks associated with such screening. The CT example is a bit extreme, because it involves ionizing radiation. However even other kinds of screening, including routine blood tests, can lead to other unnecessary and potentially harmful tests or treatments, for benign or sub-clinical conditions that would never have troubled you.
Your "gut feeling" is that you don't need check-ups, but you don't need to rely on gut feeling. Actual trials are ongoing to discover which diseases are worth screening for, when, and how; and you can trust your GP to act on the results of those trials and call you in as and when you actually need any kind of screening. In short; as a 27 year old male, you are absolutely correct, you do not need an annual check-up.
posted by roofus at 5:27 PM on March 18, 2007

I was thinking about telling my doctor that I think I coughed up blood so I could get an MRI and have everything checked out. The diagnostic tools we have are so good but it's almost impossible to convince the doctors to actually use them! MRI should be free to everyone and at the mall, followed by free liposuction done by a robotic lipostation at the mall.
posted by dela at 9:58 PM on May 30, 2007