Staying in tune with your health

by 17 Mar 2009

Health checks are an increasingly important way to prevent illness, writes Dr Benson Riddle

Health checks really form the cornerstone of what is emerging as a growing new medical speciality both here and overseas – preventive medicine. This field of medicine aims to prevent illness or injury, a direct con trast to traditional medicine that involves cur ing disease or injury after the fact.

It is also distinct from the specialty of pub lic health medicine, which works at the level of population health rather than individual health.

At an individual level, preventive medicine essentially involves regular health checks that include a health history, examination and screening tests tailored to an individual’s age, health, and family history.

The intention of screening is to attempt to identify disease early, thus enabling earlier intervention and management in the hope of reducing mortality and suffering from a dis ease. Medical bodies such as the National Health and Medical Research Council (NHMRC) in Australia and the US Preventive Services Task Force have developed preven tive health guidelines based on reviews of rigorously well-conducted and validated medical research.

Such recommendations form the basis of what Peak Health’s executive medical examn inations encompass, as they should for any healthcare provider performing such health checks on individuals. Unfortunately, however, this is not always the case, with numerous commercially oriented providers including a number of examinations and tests that prove often to be both invasive and costly, and with no recognised benefit to the patient.

It must be recognised, however, that although screening may lead to an earlier diagnosis, as with anything in medicine, screening, too, can have its disadvantages and complications.

As with any medical test, the tests used in screening are not perfect. Indeed there a number of factors that may mean a screening test is not beneficial at all:

• Adverse effects of screening procedure – eg radiation exposure from unnecessary x-rays

• Stress and anxiety caused by a test that appears positive in those without disease (false positive)

• Unnecessary further investigations and treatment in those with false positive results

• Prolonging knowledge of an illness if noth ing can be done about it

• A false sense of security caused by those tests that appear negative in those who actually do have the disease (false nega tives), which may then delay final diagnosis

• Overuse/waste of medical resources

• Unnecessary and uncomfortable procedures looking for a disease that is unlikely – eg pelvic examinations in asymptomatic women.

For these reasons, examinations and tests used in a screening, especially for diseases that are relatively uncommon, must be specif ic to the disease being screened for, in addi tion to being sensitive to picking up the dis ease itself. And this can only be determined by well-conducted medical research.

So, even though screening instinctively seems an appropriate thing to do, and having more things tested often leads people to think it is a better test, before any screening is implemented it should ideally be looked at to ensure that it does do more good than harm.

Those risk factors that appear to have the greatest impact on our long-term health – smoking, diet, level of activity, alcohol, blood pressure and cholesterol levels – are all gen erally recommended to be addressed at least annually in all adults. It therefore seems logi cal that one should participate in a health check at least annually.

By Dr Benson Riddle, head of department, Peak Health Medical Services. Contact: