A northern Ontario doctor says he's worried changes to annual physical examinations will mean some diseases and illnesses may go undetected.
As of the beginning of January, healthy patients between the ages of 18 and 64 will no longer be receiving a full annual physical. Instead, the Ontario Medical Association says patients will receive "personalized health reviews" which will involve limited examination and more discussion.
Dr. Stephen Cudmore, a family physician in Sudbury, said simply discussing a patient's heath isn't effective.
In the past, he said he's found underlying health problems even in seemingly healthy adults.
“We detected a couple breast cancers that we treated successfully,” he said.
“I would be a little worried to see what would have happened if they hadn't been in for their annual physical examinations. That's just one or two examples, there's more."
The change is part of the new agreement reached between the Ontario Medical Association and the Ministry of Health in December. The deal includes saving millions of dollars in what they say are unnecessary tests and procedures.
Family doctor and president-elect of the OMA Scott Wooder said evidence shows a head-to-toe exam for healthy people with no complaints is not helpful.
During the newly coined “personalized health reviews,” Wooder said the doctor and patient discuss specific health risks, such as smoking, or a family history of disease.
He emphasized the change does not affect children, seniors or patients with chronic conditions.
"With somebody who has diabetes for instance, there may be a much more extensive physical than in a healthy person,” Wooder said.
Wooder noted all patients will still get tests and screenings if they need them — something doctors will determine during the personalized health review.
Nevertheless, Cudmore said he will continue to give all patients full physical exams.
“I'm really concerned about 50-64 year olds,” he said.
“That's a vital time in people's lives to do annual health physicals in terms of preventative care. And now that we're going to be doing annual health reviews, I'm a little worried we're going to be missing a few things in that age group."
But Wooder said healthy adults don't need a full checkup and the health review will focus on health issues specific to each patient.
"One thing I'd like to reassure people ... (about) the changes to the annual physical (is that) there is very good evidence that it will have no negative impact on their health,” he said.
The change is expected to save the province $29 million a year.
But that number could be less if family doctors like Cudmore keep doing physicals for patients who want one.
"For me, it's a very important part of what a family doctor does,” he said. “I'm not going to change a lot in the way I practice my day-to-day medicine."