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Keep That Doctor's Appointment, Hunter Professor David Himmelstein Urges

Keep That Doctor's Appointment, Hunter Professor David Himmelstein Urges

Dr. David Himmelstein (Photo: Robin Holland)

Are routine medical checkups just a waste of time for healthy people? The notion has been creeping into recent clinical thinking and practice. However, Professor David Himmelstein of Hunter’s School of Urban Public Health, lead author of a study published in the January issue of the Annals of Internal Medicine, has come to the opposite conclusion.

The article, “Should We Abandon Routine Visits? There is Little Evidence for or Against,” is sparking conversation and drawing media attention, including an article in HealthDay for which Professor Himmelstein was interviewed.
 
His study, with co-author Dr. Russell Phillips, inaugural director of the Harvard Medical School Center for Primary Care, draws on a review of 33 studies of periodic check-ups. Based on their research, the authors challenge the notion that routine physician visits for well patients are time-consuming, unnecessary, and useless; in fact, they conclude the concept is based on insufficient evidence from an outdated review.
 
Professors Himmelstein and Phillips found that more recent evidence indicates that periodic health exams for asymptomatic patients can improve preventive services and lessen patient anxiety. They cite their own personal clinical experiences to advocate for the continuation of such visits, which they believe strengthen the doctor-patient relationship and provide opportunities for early recognition of serious conditions that might otherwise have gone undetected.  They also express concern that abolishing periodic visits might especially harm vulnerable populations--while low-income people generally have more health problems, they are less likely to visit a physician regularly.
 
Based on their review of the studies of periodic health evaluations, Professors Himmelstein and Phillips recommend that routine visits should continue to be a part of standard medical care.
 
Professor Himmelstein has co-written more than 100 journal articles and three books, including his influential and widely cited analyses of medical bankruptcy (written with Sen. Elizabeth Warren, D-MA) and the irrationally high health costs of the United States healthcare system. His 1984 study of patient “dumping”--denial of services because of inability to pay--led to the enactment of the Emergency Medical Treatment and Labor Act, which protects access to medical care regardless of economic status. He is a co-founder of Physicians for a National Health Program, and co-edits the organization’s newsletter. Professor Himmelstein is also an internist, and has served as chief of the division of social and community medicine at Cambridge Hospital, in Cambridge, Massachusetts.

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