The Truth About Annual Physical Exams and Cognition Assessment

January 12, 2018

Becky Martin, Advocacy Director
National Physicians Alliance
c: 941/518-7051

The Truth About Annual Physical Exams and Cognition Assessment

Statement attributable to Manan Trivedi, MD, MPP
President, National Physicians Alliance

In light of the annual physical exam President Trump will be having we thought it would be important to shed some light on the medical evidence around annual physical exams:

  • There is no evidence that an annual physical exam is necessary for an individual who does not have a chronic medical conditioni.
  • Many Americans, often VIPs, however still get extensive, “cadillac” level annual tests and procedures that are totally unwarranted. These tests increase costs and can lead to more harm than good.
  • Regular access to a primary care provider who can get to know you well, is much more important than an annual physical exam.
  • A focus on risk assessment followed by established, evidence-based screening at periodic intervals is the correct approach.
  • For a patient like President Trump, screenings for colorectal cancer, obesity, depression, high blood pressure, and healthful diet and physical activity should all be included as there is high certainty that the net benefit for this screening would be considered moderate to substantialii .
  • Though the current evidence is insufficient to assess the balance of benefits and harms of screening for cognitive impairment screening in older adults like President Trump, a brief cognition assessment is recommended for patients over 65 by the Center for Medicare and Medicaid Services (CMS) as part of Medicare’s annual wellness visit program (which is not a physical exam).
  • Per CMS, the cognition assessment should include an evaluation of the patient’s cognitive function by direct observation with due consideration of information obtained via reports and concerns raised by family members, friends, caretakers or othersiii .
  • As part of the cognition assessment, a screening for Mild Cognitive Impairment is often recommended and can be pursued by asking whether the patient or family member has noticed a decline in memory recently or whether they are less organized now than they were in the past.

The National Physicians Alliance seeks to create a caring and just society that improves the health of our patients and communities. Through education and advocacy, we bring together physicians across all specialties who share our values of service, integrity, and putting our patients first. We are committed to evidence-based medicine and transparency and do not accept funding from pharmaceutical or medical device companies.
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i General health checks in adults for reducing morbidity and mortality from disease: Cochrane systematic review and meta-analysis, British Medical Journal 2012; 345: e7191.
Published online 2012 Nov 20.

ii AHRQ Website:

iii CMS Website: