Intended for healthcare professionals

Practice 10-Minute Consultation

Can I have blood tests to check everything is alright?

BMJ 2023; 382 doi: https://doi.org/10.1136/bmj-2023-075728 (Published 05 July 2023) Cite this as: BMJ 2023;382:e075728
  1. Lewis F Buss, academic clinical fellow in general practice1,
  2. David Spitzer, general practitioner2,
  3. Jessica C Watson, NIHR academic clinical lecturer and general practitioner3
  1. 1Centre for Academic Primary Care, Population Health Sciences, University of Bristol, Bristol BS8 2PS, UK
  2. 2Cranwich Road Surgery, 62 Cranwich Road, London N16 5JF, UK
  3. 3Centre for Academic Primary Care, Population Health Sciences, University of Bristol, Bristol BS8 2PS, UK
  1. Correspondence to: L F Buss av22074{at}bristol.ac.uk

What you need to know

  • Many requests for check-up blood tests are motivated by a specific health concern or symptoms—addressing these specifically may be the most fruitful approach

  • Explain the limitations of blood tests in asymptomatic people, particularly the rate of false positive results

  • There are potential harms associated with over-testing that are rarely appreciated by patients. A frank discussion about when harms are likely to outweigh benefits, and vice versa, may be helpful

A 34 year old man requests blood tests for “an MOT, just to check I am OK.” He is well, asymptomatic, and takes no medication.

Patients often request a general check-up with blood tests. In the UK these are often referred to as an MOT, in allusion to the annual motor vehicle check. Some patients may, however, have unrealistic expectations of medical tests1 and underestimate their potential harms. While agreeing to some blood tests can be an easy way out for a busy clinician, it can expose patients to the harms of over-testing and produce extra workload downstream. We provide a framework for navigating these requests constructively, some elements of which are feasible within a 10 minute consultation.

What you should cover

It is important to clarify what the patient means by an “MOT.” He may have seen advertising for the NHS Health Check (https://www.healthcheck.nhs.uk/) or from the private sector; he may have prior experience of regular health check-ups from another health system.

Explore his ideas, concerns, and expectations by asking, for example, “What do you think a blood test will tell you?” or “What made you come for a check-up now?” Individuals requesting routine health checks often have specific health concerns (such as cancer, HIV infection, heart disease, family history), psychosocial issues,2 or undisclosed symptoms3 that are the true reason for seeking care. These might be elicited by a question such …

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