Nowadays, most patients head for their doctors clinics (or hospitals) for check-ups more than for any other reason. The ostensible objective is to ward off disease. In fact, of late, the annual medical check-up has become a ritual in many companies for many executives. While most patients assume that this is a standardized routine, a debate still rages in the medical profession regarding what tests ought to be performed, on whom, beginning when and how often.

Often, patients seem to fall into two extreme categories: those who get no routine medical care and those who excess medical care including screening tests, even though they do not really need them. Periodic tests and examinations should not become routine or part of a standard one-size-fits-all package. In order to be really effective, they need to be tailored according to a persons age, sex , family history and personal risk factors. Unfortunately, due to the widespread fallacy that the human body is no better than a machine, we have been taught that the body needs routine maintenance which should be performed by a doctor, much as your mechanic tunes up your car periodically. However, medical experts have debunked such an analogy as being a gross oversimplification. They have emphatically stated that screenings and early detection are not a universal panacea to ward off all ills.

At present, many people rather effusively gush: Doctor, give me the works, I want a full check-up! Many clinics now readily pander to this demand by providing a wide range of executive health check-up schemes, but often these schemes can be more harmful than beneficial ! In fact, routine tests, such as electrocardiograms, chest X-rays and full blood screening, have been found to provide little overall benefit for the healthy individual. If such is the truth, then one may well ask, why have these health check-up schemes have become so popular ? The answer is simple: they bring in the moolah! After all, much more money can be raked in by screening droves of healthy people, rather than by only taking care of sick patients. And then there is the additional lucrative bonus that the screening tests will pick up abnormalities, thus converting a formerly healthy person into a patient who needs medical attention!

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While it is true that the concept of routine testing on a regular basis sounds attractive (after all, isnt prevention much better than cure?), remember that your body is not a car! The major drawback of the tests conducted at present is that they are not very accurate. In other words, a large number of "false positives crop up; i.e., patients whose test results are abnormal but have no illness in reality! Not only does an abnormal test result create a lot of anxiety and stress but it also leads to a merry-go-round of further tests and consultations in order to determine whether or not the original result has any significance.

In fact, the only routine tests that the US Preventive Services Task Force recommends are those for blood pressure, cholesterol, colorectal cancer, breast cancer and cervical cancer. This task force refused to recommend widespread screening against other diseases for two reasons: either the tests had been found to have no merit, or there was not enough evidence to prove their benefit (i.e., they did not help to improve either life expectancy or the quality of life). In fact, screening tests could have a major negative impact on ones health, which is why they should be undertaken with a great deal of discretion and caution!
The US Preventive Services Task Force soundly criticized physicians for frittering away their valuable time on screenings of questionable value instead of counseling people about the harmful effects of smoking, lack of exercise and other risks arising due to a faulty lifestyle.

The only tests the task force recommended were:

1. Periodic check-ups for blood pressure for all adults. (High blood pressure is a leading risk factor for coronary heart disease, stroke, renal disease and heart attack.)
2. Total blood cholesterol measurement for men between the ages of 35 and 65 and women 45 to 65 (high cholesterol constitutes a risk factor for heart disease.) The frequency of testing was, however, not specified.
3. Screening for colorectal cancer for individuals over 50, by testing the stools for the presence of blood, or through sigmoidoscopy. Colorectal cancer is common in USA.
4. Mammogram (an X-ray to detect the early signs of breast cancer) for women between 50 and 69, every one or two years.
5. The PAP smear test , to screen for cervical cancer, for sexually active women once every three years.
6. Vision tests for children, before entering school, and for the elderly.
7. Tests for elderly people (or those with specific complaints) to assess hearing loss.

1. routine blood sugar testing (to screen for diabetes);
2. of thyroid hormones in the blood (to screen for thyroid disease); and
3. of bone densitometry in menopausal women ( to screen for osteoporosis) is still unclear.

1. a large number of false positive results, causing needless anxiety and concern;
2. unnecessary biopsies; and
3. harmful effects of aggressive treatments for slow growing cancers that may never have caused symptoms in a patients lifetime and could have been left well alone.