To be sure, no one is questioning the usefulness of appropriate screening tests for diabetes, high cholesterol, high blood pressure or for breast or colon cancer. The debate usually is around whether a distinct and separate visit purely for such preventive concerns is absolutely necessary.
Theoretically, nothing specifically keeps doctors from ordering some of these preventive tests during a visit for some other specific reason such as a cold or other illness, or for a follow-up visit for ongoing chronic conditions such as diabetes.
However, in reality this is not so easily accomplished. There may not be adequate time to discuss such tests in an already complex visit (nausea and weight loss in an elderly demented patient, or recent car accident with neck pain, shoulder pain and suture removal needed are mere examples). Helpful parts of the screening physical examination may not be called for at that time either (for example, listening for cholesterol build-up in the carotid arteries of the neck in a person being seen for hip and knee pain).
Also, some tests require more time, information or examination. A normal mammogram is not reassuring if there is actually a breast lump that would be noted on a physical examination. An acceptable cholesterol result is different for someone with a strong family history of heart disease or stroke than for someone else.
I, and many other doctors, find that the only way to make sure that adequate time and care can be given to the entire range preventive care is to arrange a visit dedicated to this purpose- the annual physical. I think the fact that people are living longer and having fewer heart attacks and strokes suggests we're on the right track in doing so.
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