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The value of conducting periodic health checks

BMJ 2012; 345 doi: https://doi.org/10.1136/bmj.e7775 (Published 20 November 2012) Cite this as: BMJ 2012;345:e7775

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Re: The value of conducting periodic health checks

Health checks are often put forward as the equivalent to MOT checks for cars. However, they are rather different in purpose and effect: a MOT is to prevent someone driving a dangerous car and so putting others at risk, hence the checks on tyres, brakes, windscreen wipers and the like; the equivalent for humans would be checks that you are not a psychopath and are able to drive a car (or other vehicle) safely.

The nearest equivalent to a health check is probably an annual service, which in my experience is generally a way for garages to make money and does not noticeably extend the life of my car - and may, as happened to me recently, in fact give rise to interventions that exceed the value of the car. I wonder whether the best strategy is to simply do the bare minimum (MOTs, etc.) and run the car into the ground - which is actually what most people do in terms of their health.

Screening is similar to some of the specific checks that occur in major services to try to prevent major failures which cars and people can suffer.

Doing a health check is only of some good if you do something about what you discover. When my brother hears a strange rattling in his car, he then takes it to bits and fixes it - and may gain in the long run, but perhaps not by much; I simply don't hear it or just turn the radio up louder. I fear this may be what many do anyway in terms of health, so perhaps we shouldn't be surprised that health checks don't make much difference.

Perhaps what we should do is what a wise garage would do: establish what the customer really wants in terms of their car usage, and then advise them when it is time to start thinking about changing their car. Would it help more if we educated people earlier about getting old (which is certain) and how it will affect them, so they can prepare for what may go wrong by taking some preventative action. Checking for CHD and cancer may simply start treatments early but not greatly affect outcomes.

I cannot finish without noting Dr Ian Banks' excellent 'Haynes Owners Workshop Manual: Man 120,000 BC to the present day' to try and address men's health issues - however, it too completely missed the question of aging, the most certain hazard, facing all humans and cars.

Competing interests: No competing interests

25 November 2012
Peter D Singleton
Health Informatician
Cambridge Health Informatics
Wordsworth Grove, Cambridge, CB3 9HH