Do Annual Physical Exams for Healthy Adults Have Scientific Validity?
- Jitka Burger
- Dec 4
- 5 min read
Annual Physical Exams
Annual physical exams are widely viewed as an essential part of responsible health care. Doctors recommend them, patients expect them, and insurance companies encourage them. Over time, the yearly checkup has become a cultural norm.
But does scientific evidence show that annual physicals improve health in adults who have no symptoms?
Multiple high-quality reviews—including a Cochrane meta-analysis, a U.S. Department of Veterans Affairs Evidence Brief, and guidance from the Canadian Task Force on Preventive Health Care—have reached the same conclusion:
Traditional annual physical examinations for asymptomatic adults do not reduce illness or death and are not supported by scientific evidence. [1–3]
This article explains what the research shows, why routine annual exams often create more harm than benefit, and what meaningful preventive care can look like.
What the Evidence Shows
1. No reduction in morbidity or mortality
A major Cochrane systematic review of randomized controlled trials found that general health checks did not reduce:
total deaths
deaths from cancer
deaths from heart disease
hospitalizations
long-term illness
The authors concluded that general health checks are unlikely to be beneficial [1].
The VA Evidence Brief also found no evidence that annual comprehensive exams improve outcomes in healthy adults and does not recommend them [2].
The Canadian Task Force also concluded that the annual physical examination is not evidence-based and can cause harm [3].
2. No consensus on what a “physical exam” even is
Major medical organizations do not agree on:
what should be included
how often it should occur
whether it provides any benefit in healthy adults
This lack of consensus reflects the fact that evidence does not support a standardized annual exam.
3. Potential harms: overdiagnosis and overtreatment
Although many people assume that more testing leads to better health, research shows the opposite: routine testing in healthy adults frequently uncovers incidental findings that create more harm than benefit.
Routine annual exams often include tests that are not recommended for asymptomatic adults. These tests frequently uncover incidental findings—‘incidentalomas’—small abnormalities that would never cause harm but often lead to cascades of unnecessary testing.
Once discovered, they often lead to:
unnecessary imaging
biopsies
procedures
medications
anxiety
being labeled as a “sick patient” without having a real illness
This is overdiagnosis, and treating overdiagnosed conditions is overtreatment. Patients do not benefit because the condition would never have affected their health or lifespan.
Overdiagnosis:
turns healthy people into patients
shifts focus from true health to chasing meaningless abnormalities
creates additional emotional, financial, and medical burdens
For readers who want to explore this topic more deeply, an excellent resource is the book Overdiagnosed: Making People Sick in the Pursuit of Health by H. Gilbert Welch, Lisa Schwartz, and Steven Woloshin. The authors clearly explain how modern medical testing can turn healthy people into patients by identifying abnormalities that would never cause harm. You can also watch Dr. Welch’s keynote presentation, “Over-Diagnosed: Making People Sick in the Pursuit of Health,” delivered at the February 2012 Advanced Study Weekend hosted by Dr. John and Mary McDougall. It offers a clear, accessible overview of how overdiagnosis happens and why it matters for anyone considering routine testing. Link: https://www.drmcdougall.com/education/lectures/h-gilbert-welch-over-diagnosed/
Preventive care should aim to:
Help people who are truly sick, not those caught in disease-mongering.
Ensure that all treatment goals are appropriate, evidence-based, and truly necessary.
What Would Make an Annual Visit Truly Useful?
If an annual visit is going to be done, it should focus on real determinants of health, not unnecessary testing. A simple starting point is to ask patients how they would rate their own health, which is often a more accurate predictor than routine testing.
A truly meaningful visit should focus on the real drivers of health rather than a checklist of routine tests. This includes the foundations of lifestyle—diet, physical activity, sleep, and stress management—along with key indicators of metabolic wellbeing, such as sustainable weight, muscle strength, and waist circumference. It also involves mental and social health: satisfaction in daily life, supportive relationships, emotional stability, and a sense of connection.
Instead of hunting for disease in people who feel well, a clinician should ask about early symptoms or concerns, offer practical evidence-based strategies for improving health, and avoid unnecessary tests that can trigger cascades of follow-up procedures without benefit.
Whole-person care means viewing patients as human beings rather than lab values. Clinicians should explain the root causes of disease, use the least invasive treatments first, provide education and support for lifestyle improvements, and give clear, unbiased explanations of all options. Informed consent requires discussing what is being recommended, why, and the risks, benefits, and consequences of doing—or not doing—the test or procedure.
Decisions about tests, treatments, and procedures should always belong to the patient. The clinician’s role is to provide clear information—not to direct or pressure. Patients should never feel pushed into any test or intervention that is not clearly necessary.
Key Points
Annual physical exams for asymptomatic adults do not improve health outcomes. [1–3]
Evidence does not support routine tests performed solely because it is “that time of year.”
Harms come mainly from overdiagnosis and overtreatment, not missed disease.
A far more meaningful approach focuses on lifestyle, risk reduction, mental wellbeing, and informed decision-making.
Anyone with symptoms should seek prompt evaluation—this evidence applies only to people who feel well.
Conclusion
The scientific evidence is clear: traditional annual physical examinations for healthy adults provide no measurable benefit and carry real risks. Their popularity is cultural, not evidence-based.
What truly promotes long-term health is a thoughtful, whole-person approach that emphasizes lifestyle, emotional wellbeing, informed consent, and root-cause explanations—rather than unnecessary testing.
References:
[1] Krogsbøll LT, Jørgensen KJ, Gøtzsche PC. General health checks in adults for reducing morbidity and mortality from disease. Cochrane Database Syst Rev. 2019;1(1):CD009009. Published 2019 Jan 31. doi:10.1002/14651858.CD009009.pub3
Link: https://pubmed.ncbi.nlm.nih.gov/30699470/
[2] Bloomfield HE, Wilt TJ. Evidence Brief: Role of the Annual Comprehensive Physical Examination in the Asymptomatic Adult. Washington (DC): Department of Veterans Affairs (US); October 2011.
Link: https://www.ncbi.nlm.nih.gov/books/NBK82767/
[3] Birtwhistle R, Bell NR, Thombs BD, Grad R, Dickinson JA. Periodic preventive health visits: a more appropriate approach to delivering preventive services: From the Canadian Task Force on Preventive Health Care. Can Fam Physician. 2017;63(11):824-826.
Link: https://pmc.ncbi.nlm.nih.gov/articles/PMC5685441/
Additional background evidence on routine exams and preventable harm:
Hopkins Tanne J. Annual check-ups aren't needed, US study says. BMJ. 2007;335(7621):631. doi:10.1136/bmj.39349.383194.DB
Link: https://pmc.ncbi.nlm.nih.gov/articles/PMC1995475/
Redefining the Annual Physical: A (Broken) Window Into American Healthcare - Medscape - Jan 15, 2015., Accessed December 3, 2025
https://www.medscape.com/viewarticle/838132#
The New York Times. January 8, 2015. Skip Your Annual Physical. The New York Times. January 8, 2015. Accessed December 3. 2025
Link: https://www.nytimes.com/2015/01/09/opinion/skip-your-annual-physical.html?smid=url-share
Dr. McDougall. The Annual Physical Exam – A Ritual to Be Avoided. Accessed December 3, 2025
https://www.drmcdougall.com/education/information-all/annual-physical-exam-ritual-to-be-avoided/
Disclaimer: I am a Certified Plant-based Health Educator, not a medical doctor. My goal is to present you with available evidence that will make your decision easier. The information I share is for educational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. You are advised to do your own research and make informed decisions in partnership with your physician(s). If you are on medication and are switching to a whole-food, plant-based diet, it is important that you work with your doctor to monitor your condition and medication dosage during your change of dietary practices.
I encourage you to critically evaluate any claims and make informed decisions that support your long-term health and well-being.
