Public Expectations and Attitudes for Annual Physical Examinations and Testing

7 May 2002 | Volume 136 Issue 9 | Pages 652-659

Background: Recent guidelines for adult prevention do not recommend a comprehensive annual physical examination, but current public expectations in light of this change are unknown.

Objective: To determine public belief in the need for and content of an annual physical examination and to examine the effect of financial charges on these beliefs.

Design: Telephone survey.

Setting: Three U.S. cities.

Participants: Adult English-speaking respondents.

Measurements: Percentage of respondents answering that an annual physical examination is necessary and percentage desiring individual components of the history, physical examination, and laboratory testing, with and without knowledge of charges.

Results: Of 1203 respondents, 66% (67% in Denver, Colorado; 71% in Boston, Massachusetts; and 58% in San Diego, California) believed that in addition to regular care, an annual physical examination is necessary. Among the 600 respondents presented with charge information, interest decreased from 63% to 33% if payment were required. For history, greater than 90% believed that diet, exercise, and tobacco and alcohol use should be discussed, while 60% believed that seatbelt use and sexual history should be discussed. For the physical examination, greater than 90% felt that blood pressure should be measured and that the heart and lungs, abdomen, reflexes, and prostate should be examined. However, fewer than 80% thought that hearing and vision should be tested. Many tests, including the Papanicolaou smear (75%), mammography (71%), cholesterol measurement (65%), prostate-specific antigen test (65%), urinalysis (40%), blood glucose measurement (41%), fecal occult blood testing (39%), and chest radiography (36%), were desired. Interest in these tests decreased substantially when the charges were known.

Conclusion: Public desire for a comprehensive annual physical examination is high across the United States and is sensitive to charges.

Editors' Notes Context Recent preventive health guidelines recommend against comprehensive annual examination of healthy adults. Yet, many Americans are accustomed to receiving such examinations. Contribution This population-based survey of adults in three U.S. cities suggests that many people expect annual physical examinations that include many tests (for example, complete blood counts) that prevention guidelines do not recommend. Conversely, adults do not feel strongly about receiving tests and counseling that have proven benefit. Desires for tests decrease as out-of-pocket costs increase. Implications Public education about preventive health interventions is needed. –The Editors

 

Author and Article Information

From Denver Veterans Affairs Medical Center, Denver Kaiser Permanente, and University of Colorado Health Sciences Center, Denver, Colorado.

Requests for Single Reprints: Sylvia K. Oboler, MD, 11B Ambulatory Care, Denver Veterans Affairs Medical Center, 1055 Clermont Street, Denver, CO 80220.

Current Author Addresses: Drs. Oboler and Prochazka: Denver Veterans Affairs Medical Center, 11B Ambulatory Care, 1055 Clermont Street, Denver, CO 80220.

Drs. Gonzales and Anderson: Division of General Internal Medicine, University of Colorado Health Sciences Center, 4200 East Ninth Avenue, Campus Box B-180, Denver, CO 80262.

Dr. Xu: Biostatistics, Clinical Research Unit, Kaiser Permanente, 10350 East Dakota Avenue, Denver, CO 80231.

Author Contributions: Conception and design: S.K. Oboler, A.V. Prochazka, R.J. Anderson.

Analysis and interpretation of the data: S.K. Oboler, A.V. Prochazka, R. Gonzales, R.J. Anderson.

Drafting of the article: S.K. Oboler, A.V. Prochazka, R. Gonzales, R.J. Anderson. Critical revision of the article for important intellectual content: S.K. Oboler, A.V. Prochazka, R. Gonzales, R.J. Anderson.

Final approval of the article: S.K. Oboler, A.V. Prochazka, R. Gonzales, R.J. Anderson.

Provision of study materials or patients: S.K. Oboler.

Statistical expertise: A.V. Prochazka, R. Gonzales, S. Xu.

Obtaining of funding: R.J. Anderson.

Administrative, technical, or logistic support: R.J. Anderson.

Collection and assembly of data: S.K. Oboler, R.J. Anderson.