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A Psychologist's Thoughts on Clinical Practice, Behavior, and Life

The Annual Medical Exam

An article in The Wall Street Journal ("The Case Against an Annual Physical"/Feb. 19, 2024) aroused several thoughts.

The basic problem is that many illness are caused by lifestyle issues that doctors are loathe to address and patients are loathe to hear and usually ignore. A nurse told me that 90% of the patients in her hospital were over 300lbs. and ignored medical advice about diet. Another basic problem is that doctors are paid by procedure and not giving advice so which do you expect gains priority?


Having fortunately been healthy, I once told a physician that I didn't think I could get a chronic illness and she responded, "That's a good delusion. Keep it," which is true. But invasive unneeded tests can be dangerous. Read, "Should I Be Tested For Cancer? Maybe Not And Here's Why" by H. Gilbert Welch, M.D., M.P.H. A noted book that I bought five copies for relatives.


The skill of a doctor is critical too. I've Twittered that Americans are in far greater danger of being killed by their family doctor than a terrorist. One more thing: drug companies tend to exaggerate the purported benefits and downplay the potential side-effects of their wares. Nuff said.

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The Police Officer, The Doctor, And The Annual Medical Exam

While apparently dissimilar, the work of the police officer and the doctor share an essential characteristic since both must wait for the undesired event to occur before intervening: the police officer for the crime and the doctor for the symptom, both of which may be long in development. No law or medical guideline allows personal rights to be violated regardless of potential benefit to society or the individual.
Following the medical model of treatment bars intervention until an illness is apparent, a corollary principle being that no illness should be ignored. To resolve this conflict demands an uncommon level of practice, the ability to note subtlety of words and tone and behavior within the framework of psychological knowledge.Thus does the ritualized annual health check-up have minimal effect on critical issues for it ignores the early stages of psychological stress from internalized childhood psychological development issues and family and work that can lead to organic illness. 

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