June 30, 2021
David Burda
Outcomes Policy System Dynamics
Blogs Dispatches

Primary Care Predeterminism

Healthcare’s “it girl” right now is primary care. Everyone wants to provide it. Everyone wants to provide it in new models. Everyone wants to provide it as part of their omnichannel care delivery platforms. We can’t get enough of primary care.

Why? The market has decided that primary care is the best way to create value now and into the future. For patients, it’s clinical value defined by better health status and outcomes. For primary-care providers, it’s financial value defined by lower medical costs and predictable income.

The vehicle that patients and providers are counting on to delivery that value is the annual checkup, also known as the routine exam or wellness visit. As we all know, the theory is that by catching any potential health problems early, we’ll avoid more serious and more costly health problems later. Not all of us buy that theory, thinking it’s mostly a waste of time and resources that would be better spent on someone displaying actual symptoms of an injury or illness. 

Well, a new study in the Journal of the American Medical Association puts that debate to rest. The good news is, annual checkups, routine exams and wellness visits do make you healthier and feel better. But the bad news is, you won’t live any longer because of it. You can download the study here

Five researchers from the medical school at Northwestern University pored through published results of 19 different clinical trials and 13 different observational studies to reach that conclusion. All 32 pieces of research were published between January 2000 and March 2021.

In its meta review of the medical literature, the researchers found a positive connection between annual checkups, routine exams and wellness visits and the following: 

  • Increased detection of chronic diseases
  • Reductions in clinical risk factors like high blood pressure, high cholesterol levels and obesity
  • Increased use of other preventative medical services
  • Higher rates of healthy behaviors like exercise, diet and smoking cessation
  • Improvements in patient-reported outcomes like quality of life and self-rated health status

What the researchers didn’t find was any positive connection between annual checkups, routine exams and wellness visits and the following: 

  • Improvement in patient mortality
  • Improvement in cardiovascular outcomes

“General health checks were not associated with reduced mortality or cardiovascular events,” the researcher said.

That said, the researchers still thought an annual checkup was a good idea.

“Primary-care teams may reasonably offer general health checks, especially for groups at high risk of overdue preventive services, uncontrolled risk factors, low self-rated health, or poor connection or inadequate access to primary care,” they added.

From a business model perspective, this is good news for primary-care providers. An annual checkup gets your patients’ health issues under control and your long-term operating costs under control.

From a clinical perspective, this also is good news for patients. An annual checkup will make you feel better and feel better about yourself. That is, until you die, which, at least according to this study, was going to happen about the same time anyway whether you went to the doctor or not.

Thanks for reading! 

To learn more about this topic, please read “Primary-Care Physicians Versus the World on 4sighthealth.com.

About the Authors

David Burda

Dave is 4sight Health’s biggest news junkie, resident journalist and healthcare historian. He began covering healthcare in 1983 and hasn’t stopped since. Dave writes his own column, “Burda on Health,” for us, contributes weekly blog posts, and manages our weekly e-newsletter and weekly podcast, 4sight Friday and 4sight Roundup. Dave believes that healthcare is a business like any other business, and customers—patients—are king. If you do what’s right for patients, good business results will follow. Follow Burda on Twitter @DavidRBurda and on LinkedIn.

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