Can an " Annual Lab Screen " Serve as a Replacement for the Annual Physical Exam

During my career in pathology, there has been a constant litany of complaints from various quarters about excessive ordering of lab tests. And yet, all the while, a complete blood count (CBC) and other lab tests such as electrolytes, lipid panels, and renal panels have been routinely ordered as part of periodic physical exams as a means to screen for diseases that might not be recognized during the physical exam itself. However, the annual physical exam itself has been criticized by many as being unproductive (see: Is the Annual Physical Unnecessary?). The following arguments were marshaled in this article to underscore this point:By the 1980s, doctors had begun to question which components of the annual physical were worthwhile. Little by little, practices changed. Annual CBCs, urinalyses, TB tine tests, and chest x-rays were found to be useless and were dropped.Pap smears and STD screening were proven worthwhile, but the routine pelvic exam with speculum and bimanual palpation was not.The physical examination of a healthy, asymptomatic adult is unlikely to reveal any significant abnormality (1) that would not have been detected eventually when symptoms developed and (2) whose earlier detection and treatment would reduce morbidity and mortality in the long run.I will readily concede that a yearly physical may have minimal value in detecting diseases that might otherwise be detected early in a healthy asymptomatic adult. However, many of the routine lab tests ordered as...
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