In an article from Dr. Ezekiel Emanuel, Vice Provost at the University of Pennsylvania, another strong case is made against a staple of corporate wellness programs – annual physicals or biometric screenings. Despite annual physical exams being worthless from a health perspective, 45 million Americans are planning on having one this year and many of those encounters are a result of incentives provided by employers or health plans. These checkups consume billions of dollars, although no one is sure about how many billions because of the challenge of measuring the additional screenings and follow-up tests. Dr. Emanuel tries to articulate how these clinical encounters are costly and wasteful to an individual and our healthcare system. Below are some highlights.
- In an analysis of 14 randomized controlled trials with more than 182,000 people, the Cochrane Collaboration concluded that physicals are unlikely to be beneficial regardless of which screenings and tests were administered. The study showed that physicals did not reduce mortality overall or for specific causes of death from cancer or heart disease.
- The United States Preventive Task Force (USPTF) is an independent group of experts that make evidence-based recommendations about the use of preventative services. Their guidance should shape corporate wellness programming. The USPTF does not recommend routine annual health checkups. The Canadian guidelines have recommended against these exams since 1979.
- Annual physicals do little to avert death or disability from acute problems. Unintentional injuries and suicides are the fourth and tenth leading causes of death amongst Americans, respectively. Also, physicals do little for chronic conditions without significantly useful interventions, such as Alzheimer’s (the fifth leading cause of death for Americans).
- Thousands of screenings will yield minimal identifications of diseases, many of which do not provide a benefit from early diagnosis.
- Some people are actually hurt by physicals. Healthy patients who undergo an exam sometimes end up with complications and pain from further screening or confirmatory tests, all of which cost more money.
Despite the overwhelming evidence that people should not have annual physicals, more and more employers are including biometric screenings as a pillar of their wellness programs. Many budget constrained organizations do so at the cost of not having effective solutions. Employers should make evidence-based decisions and drop the biometric screenings from their wellness program.