The annual physical may not be all that it’s cracked up to be. According to a review involving more than 180,000 people, health checkups – defined as “annual physicals or other visits to the doctor by asymptomatic people” – were deemed “ineffective and possibly harmful.”

The “ineffective” assessment stems primarily from finding no substantive mortality, hospital admission, disability or time-off-work differences (among other measures) between control groups and test groups. The “possibly harmful” notion seems to primarily stem from overtreatment situations and their potential consequences.

Looked at another way, maybe the annual physical has simply been somewhat unintentionally compromised and needs its own checkup. Consider a conversation centered on nutrition and healthy lifestyle, supplemented by physical diagnostics and measures that assess progress towards health-promoting goals (what gets measured gets done), in place of a visit with the forced focus of gatekeeping specialty care, the provisioning of medical tests, or the distribution of pharmaceuticals. Odds are pretty good the first scenario would test differently than the second.

There’s no question that preventive health matters, and that the front line of prevention and cost-effective early intervention should be primary care. That doesn’t mean that the work of primary care shouldn’t be double-checked and realigned, if necessary, with the ultimate goal of a healthy, happy, and productive human being.