Periodic Health Examination

Two parallel cultures of health have existed since ancient times: healing (the traditional role of physicians), and staying healthy. Other than public health procedures (e.g., provision of a clean water supply, reduction of overcrowding), serious attempts to prevent illness by interventions on an individual level began only in the twentieth century. The annual physical examination was established as an attempt to detect and treat illnesses before they caused serious harm. The annual physical examination became increasingly complex and comprehensive, including the use of laboratory tests, X rays, and various procedures; culminating, in the 1960s and 1970s, with the executive check-up. Such procedures discovered numerous abnormalities (which occur more frequently, by chance, as the number of tests increases), yet failed to produce overall better health. With this realization, the concept of targeted preventive health care procedures emerged in the 1970s and evolved into the periodic health examination (PHE).

Epidemiologic studies have revealed the most common causes of death among older people to be cardiovascular diseases (especially heart attacks and heart failure), strokes, and malignant diseases (cancers). Disability is produced by a wide range of conditions, including complications of cardiovascular diseases, musculoskeletal disorders (arthritis, fractures), strokes, and problems with the special senses (i.e., hearing and eyesight). Risk factors are phenomena that are associated with disease. For example, tobacco smoking is strongly associated with lung cancer and heart disease. Risk factors may be modifiable (e.g., lowering blood pressure reduces the risk of stroke), or nonmodifiable (e.g., age, family history of certain diseases, genetic disorders). Knowledge of the epidemiology of diseases, their risk factors, and specific treatments has laid the foundation for the study of preventive health care.

The PHE evolved from the annual check-up. It consists of a list of procedures that target specific conditions or their risk factors, and it aims to reduce subsequent illness, disability, and premature death. While the PHE is offered to individuals who visit their personal physicians for the purposes of prevention, components of the PHE may be offered on other, opportunistic, occasions, such as counseling against smoking when an individual consults a physician for cough.