Prochazka et al1 address the lack of evidence for the annual examination. In the accompanying editorial, the authors ask if physicians and patients might be telling us something by their preference for it.2
As one of the first 16 physicians recognized for both cardiovascular prevention and diabetes care by the National Committee for Quality Assurance, as a member of a clinic whose patient satisfaction was ranked top 10 in the nation, and as a physician committed to patient-centered quality, what I would tell is this: I structure my entire practice around the annual examination. It is when I address prevention, coach patients on healthy lifestyles, and do the annual review of each chronic medical condition. Invariably, patients bring new symptoms for evaluation as well. It is a complex visit, focused on integrated, longitudinal care.