The Myth of the Preventive-Only Visit

The annual physical examination is a staple of North American medicine. Medicare does not pay for such visits, and the United States Preventive Services Task Force designates these visits as preventive services.

To understand the expectations of receptionists, patients, and physicians as well as their reasons for scheduling a health maintenance visit and to clarify the expectations of patients and providers regarding delivery of clinical preventive services during these visits.

Cross-sectional survey of patients (20 years and older) in a group practice who called to request an appointment that receptionists interpreted as a health maintenance visit.

Description and differences between expectations of receptionists, health care practitioners, and patients regarding expectations for the periodic health maintenance visit.

The study included 185 patients between ages 21 to 85 years, for whom a period health visit was scheduled by receptionists when the patient called to ask for a "physical," "annual exam," "general checkup," or "Pap [smear]." Of the 185 patients, 126 (68%) described acute or chronic complaints. Patients and clinicians expected acute and chronic disease care to occur during the health maintenance visit. Patients expected health maintenance visits to last longer than clinicians expected these visits to last (p < 0.001). No significant difference was seen between expectations of patients and those of clinicians about providing preventive care, blood tests, other laboratory tests, care for chronic or acute complaints, or prescription refills during the health maintenance visit.

Although the periodic health visit has been given an assortment of names to indicate that the visit is intended for prevention, patients consider the visit to be an opportunity to ensure that all their health care needs are met.