Rethinking Annual Wellness Visits

May 14th, 2018

When we discuss preventative medicine and ways we can take responsibility for our health, annual wellness visits might come to mind as a means to accomplishing both. It seems to be part of the conventional wisdom most of us abide by, at least in theory. We may not make that visit every year, but we know we should. Or should we?

Over the last several years, there has been a shift on this topic, with more and more physicians saying there is a better way to approach wellness. In fact, there is a growing body of evidence revealing that annual wellness visits or physicals are not necessary or effective, and in some cases, may actually be harmful. For more information, feel free to review these two articles: You Asked: Do I Really Need an Annual Physical? and Are Annual Physicals Necessary?

Here are some of the "pros" of annual physicals: in some cases, they can lead to the early detection of disease through routine testing. Additionally, as this may be the only time of year when some patients interact with their providers, it allows for them to establish a relationship and rapport they might otherwise lack.

However, the "cons" to annual physicals are more numerous and weighty: for one, the many false positive results that come from some testing create an undue emotional and mental burden on patients. In extreme cases, those patients may actually go so far as to undergo treatment for a disease from which they ultimately discover they are not suffering. These physicals and wellness visits also constitute a drain on physician time and on resources used for testing that is unlikely to reveal anything of significance.

There are several examples of this disparity between investment and overall benefit, including where annual mammograms for breast cancer screening are concerned. The truth is, over time, routine mammograms have not been shown to lower breast cancer mortality rates among women. In fact, there is real concern that exposing women to radiation through mammography may actually raise their risk of cancer. For more information on this, check out Mammography: More Harm Than Good? on our blog.

Ideally, patients would establish a trusting relationship with their providers so they feel comfortable discussing any symptoms they experience as soon as they notice them. Additionally, in consultation with providers, patients can and should talk through their history and risk factors to set a schedule of wellness visits and diagnostic testing that makes sense for their individual situation, rather than using a one-size-fits-all approach. Patients, with the help of their physicians and the many resources of which they can avail themselves, should educate themselves so they can act when something of real concern comes up.

For Liberty HealthShare members, cost-effectiveness is one of the main factors in our approach to this topic. We constantly work to remind our members that this is a community of patients who have voluntarily agreed to share in one another's eligible healthcare costs. Our members are viewed by the healthcare system as self-pay patients. That status and our values of financial stewardship are pieces of information our members can and should share with their physicians. Good doctors will not only be excited to hear that their patients understand the need to conserve resources and keep costs low but will also partner with them to make that a possibility.

As you make a plan with your provider to achieve your health goals through appropriate, timely examinations and testing, don't be afraid to bring up the fact that, where certain screenings are concerned, there are now alternative methods available. For instance, instead of the routine colonoscopy for colon cancer screening, there is now a test called Cologuard. Some physicians may recommend thermography for breast cancer screening in certain patients instead of a mammogram. And instead of a PSA test, your physician might agree that self-monitoring and manual examinations for prostate cancer screening are just as effective.

No matter which approach you take, the key is to do it in communication with your physician. Liberty HealthShare exists to facilitate the sharing of medical costs among its members, so it's no secret that we are invested in protecting the material resources of our membership. That is what makes it possible for us to serve all of our members well. However, we have no desire to insert ourselves into the patient/physician relationship. In fact, that's one of the things that makes us unique: we encourage you to make informed decisions with your provider's input rather than tailor your medical care to a system governed by regulations and statistics.

One note for members who are or were enrolled in our HealthTrac provisional program: following your graduation from the program, you will be monitored both quarterly and through annual physicals to ensure you are maintaining your goals.

If an annual physical and routine testing is the regimen you and your physician agree is best for your individual risk factors and history, Liberty HealthShare does share in one wellness visit per year, including any associated testing, up to a total of $400. Refer to item IV. C. 21. (Screening and Wellness Visits) in your Sharing Guidelines document for specifics regarding certain tests and associated age ranges. Keep in mind that, as a member, it is your responsibility to make yourself familiar with the Sharing Guidelines and to discuss with our staff any testing outside what is traditionally recommended.

More than anything, we at Liberty HealthShare want to encourage you to develop a relationship and open conversation with your physician so you can develop a plan of care that makes sense for you, your health profile, and your values. Educate yourself, ask questions, and respond wisely to the information you get. We believe every one of our members is unique and that his or her care and wellness plan should reflect that. For your physical, mental, and emotional health, we want to support you as you take charge of your care.