Each of the authors notes that the annual physical is often seen as an opportunity to establish or reaffirm the doctor-patient relationship; both articles consequently discuss establishing some form of “relationship maintenance” visit. Drs. Mehrotra and Prochazka propose limiting such visits to the subset of patients who don’t already visit their physician for specific medical concerns, while Dr. Goroll supports a broader conversion of the annual physical into an “annual health review”.
How intertwined are the doctor-patient relationship and the annual physical? If the encounter is eliminated (or made less frequent), is there a risk of damaging the trust and familiarity that characterize an ideal doctor-patient relationship? Conversely, if the annual physical is simply modified to explicitly focus on relationship maintenance and/or a tailored health review, do we really move the needle with regard to value (both in terms of health system costs and physicians’ time)?
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