I read with great interest the recent article in the ARCHIVES by Dr Gordon et al1 questioning the use of the annual complete physical examination (CPE). In 3 years of practice since completing my internal medicine residency, I have begun to suspect what Gordon et al suggest in their well-referenced article, namely, the lack of medical justification for the CPE in many cases.
Gordon et al conclude with the suggestion that perhaps as many as 11 million unnecessary office visits for CPEs are made in this country each year at great expense to the health care system. I would like to add that Gordon et al may, in fact, underestimate the cost of unnecessary CPEs, if one also accounts for the time and resources spent completing "Physical Exam" forms for camp, school, work, etc. Many of these forms, to my continued amazement, require much greater detail than a standard preoperative evaluation. I have not calculated the amount of time I spend each year filling out such forms, but I suspect it is substantial, and I suspect also that I am not alone.