A reasonable guideline would be twice in their 20s, three times in their 30s, four times in their 40s, five times in their 50s, and annually thereafter. Attempts to apply scientific rigor to what should be included in the history, the physical, and screening laboratory studies can argue that almost none of this is cost effective; yet I feel that periodic examinations are a good way for doctors and patients to get to know one another, to identify risk factors, to discuss lifestyle issues and to review immunizations while discussing benefits, risks, and costs of screening procedures. It is helpful to have an established relationship with a personal physician when dealing with intercurrent illness or major health problems. Personal physicians also represent an excellent source of referrals to other healthcare providers as these needs arise. Additionally, a personal physician can be a helpful sounding board in talking through recommendations from other specialists.
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