Annual Physical

The annual physical is also known as a health maintenance visit, routine physical, periodic examination, or regular checkup. No matter what its name is, its purpose is preventive care (preventive medicine). Preventive care can help avoid illness and improve personal health. Regular exams with a physician can help check for illnesses before symptoms appear; this encourages a healthy lifestyle, which is the cornerstone of preventive care. 

Regular physical exams may not always be annual events. Annual physicals were once standard, but that is no longer the case. In the 1980s, some health experts changed their attitudes about what constitutes best practices for routine physicals. In the past, guidelines recommended that all adults be examined once a year and undergo the same set of diagnostic tests, regardless of health, family history of disease, or other risk factors. Experts may recommend less frequent exams and screening tests based on age, sex, and personal risk factors.

Brief History

The annual physical in the United States is rooted in the early twentieth century. At the start of the century, people typically saw a doctor only if they were gravely ill, injured, or giving birth. By the 1920s, the concept of health examinations to detect illnesses prior to a person becoming sick had been introduced. Both the American Medical Association (AMA) and the American Public Health Association (APHA) advocated annual health examinations for all people. The APHA campaigned with the slogan, "Have a health examination on your birthday." The annual physical gained the support of the public, who considered detecting serious illnesses before symptoms appeared an ideal way to stay healthy. By the 1940s, annual physicals were the norm.

Over time, however, some medical professionals questioned the efficacy and cost-effectiveness of annual physicals. It was evident that screening could not detect all possible illnesses. A person could have an annual physical and experience a brain aneurysm a short time later. In addition, screening sometimes resulted in false positives or test results that falsely indicated a person had a serious illness. This resulted in additional medical testing that was unnecessary and costly. It also created unwarranted stress for the patient.

By the 1980s, concerns about the value of annual physicals had grown, and the US Preventive Services Task Force (USPSTF) was commissioned to examine the issue. It evaluated the screening tests used by physicians and determined that many of the tests did nothing to improve a person’s health or lengthen their survival in case of illness. Based on these results, the USPSTF issued the Guide to Clinical Preventive Services: An Assessment of the Effectiveness of 169 Interventions report in 1989 that revolutionized preventive care. Past guidelines had recommended that all people receive the same set of screening tests every year, regardless of health, family history of disease, or risk factors. The new guidelines recommended screening for diseases based on age, sex, and other personal criteria. The new guidelines also recommended less frequent checkups, finding no medical evidence to support a physical every year.

Many medical professionals concur with the USPSTF’s call for less frequent physicals; however, there is some disagreement among physicians and medical associations as to how often and under what circumstances specific screening tests should be performed. For example, the USPSTF recommends mammograms to detect breast cancer every two years for women between the ages of forty and seventy-four, while the American Cancer Society recommends annual mammograms for all women between the ages of forty-five and fifty-four, then switching to every two years, or continued yearly screening, for women aged fifty-five and older.

In 2010, preventive care was strengthened with the passage of the Patient Protection and Affordable Care Act. It required most non-grandfathered private health plans to cover all the costs for specific preventive care services on or after September 23, 2010.

Annual Physical Today

The annual physical has shifted from a battery of screening tests to preventive services based on a patient’s needs. Perhaps the biggest change in routine physical examinations is the emphasis on patient behavior. Physicians recognize that many illnesses, such as diabetes, heart disease, and liver disease, are affected by diet, exercise, and tobacco and alcohol use. A primary goal of the routine physical is to counsel patients on how they can change their health through their behaviors.

During an annual physical, a physician assesses a patient’s health and risk for disease through an interview and physical examination. The interview includes detailed questions about the patient’s medical history, behaviors, and family medical history. The physical examination generally includes taking measurements of the patient’s height, temperature, weight, and blood pressure; listening to the heart and lungs; pressing against the patient’s abdomen; and examining the eyes, ears, and nose.

The physician also discusses any health concerns with the patient and counsels the patient on lifestyle choices and behaviors. Adults and children will have specific concerns confronted at their annual physical.

Overview of Screening Tests Guidelines

A physician may order medical screening tests based on the patient’s age, sex, and health risk as recommended by the USPSTF. The following is a brief overview of those guidelines.

Adults between the ages of eighteen and forty-nine should have their blood pressure taken at least annually if they are at high risk for hypertension, but otherwise, they may be screened every three to five years. Women aged twenty-one to twenty-nine should have a Pap test every three years, and women aged thirty to sixty-five can choose between a Pap test every three years or co-testing with the human papillomavirus (HPV) every five years. Women aged twenty-four and younger who are sexually active should be tested annually for chlamydia, and women aged twenty-five and older should be tested if they are at increased risk owing to new, multiple, or infected partners. Adults with high blood pressure should be screened regularly for prediabetes and type 2 diabetes; persons with a risk for heart disease should be screened regularly for cholesterol; and persons who are at increased risk for HIV should be screened regularly for the human immunodeficiency virus (HIV). In addition, HIV screening is recommended at least once for most adolescents and adults aged fifteen to sixty-five.

Patients aged forty and older should have their blood pressure tested every two years. Patients should also be screened for colorectal cancer, beginning at age forty-five, until age seventy-five. Women should have a mammogram every two years from age forty up to age seventy-four, have a Pap test every three years if they are younger than sixty-five, and have a bone mineral density test every year up to age seventy-four if they are at risk for osteoporosis (in the absence of any risk, women aged sixty-five and older must have this test). Patients who are at risk for other illnesses, such as sexually transmitted diseases, heart disease, and diabetes, should also have screening tests. Men should have an abdominal aortic aneurysm screening at least once if they have ever smoked.

Bibliography

“A and B Recommendations.” U.S. Preventive Services Task Force, www.uspreventiveservicestaskforce.org/uspstf/recommendation-topics/uspstf-a-and-b-recommendations. Accessed 24 Mar. 2026.

“Colorectal Cancer: Screening.” U.S. Preventive Services Task Force, 18 May 2021, www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening. Accessed 24 Mar. 2026.

McLaughlin, A. J. “Health Examination Plans of National Health Council.” Proceedings of the Thirty-Seventh Annual Meeting, Wynkoop, 1922, pp. 129–30.

“Physical Examination.” Cleveland Clinic, 14 Apr. 2023, my.clevelandclinic.org/health/diagnostics/17366-physical-examination. Accessed 24 Mar. 2026.

Seed, Shawna. “Annual Physical Examinations.” WebMD, 31 May 2024, www.webmd.com/a-to-z-guides/annual-physical-examinations. Accessed 24 Mar. 2026.