Wednesday, February 20, 2013

Annual Physical vs. a Personal Health Visit

Some may be shocked to find that the OHIP-funded 'Physical' has been replaced by a personal health visit by a patient to our healthcare practitioner. But the research supports this change.

We know how difficult it is to change, and I suspect that physicians will be the ones most peeved with this change. I have seen the changes in healthcare practices in Ontario. We have been evolving the system, based on good research. Truthfully, if you have no symptoms, it is unusual for Primary Care to find a hidden disease in an otherwise health individual, then OHIP will no longer fund this major annual physical examination. In patients with a high-risk profile, such as a smoker, the obese, the very young and the elderly, then OHIP will continue to fund the full examination.

We are moving from the one size fits all approach to one that accommodates individual determinants for healthcare practices and strategies. For those with chronic illnesses, a full examination may or may not be necessary. That said, during a visit to manage prescriptions, for example, this regular appointment can be used to take vital signs and determine baseline blood pressure, for example.

What do the smart physicians and nurse practitioners focus on?
PREVENTION: eat balanced meals, mostly plants; avoid cigarettes and alcohol; exercise; watch your weight; watch your cholesterol; watch your blood pressure; socialize; keep busy; get the proper amount of sleep.

Many screening tools, such as the PSA or mammograms, have found to have high false positives test results, which put both the patient and the system at risk. For the patient, the emotional toll on having a false positive test is horrific. Many taking the PSA blood test find that this broad screening test reveals high positive results, based not on a cancer diagnosis, but on individual practices such as bike riding, or a change in behaviour. This person then takes the more expensive more specific test, to rule out prostate cancer while he changes his behaviour to resolve the issue. This is the difference between screening and diagnosis of cancer.

 Supporting Evidence and For More Information


Personal Health Visit

A personal health visit is a regular medical assessment or examination ... OHIP funds physical reviews or exams for each patient, up to once a year. ... The fee for the annual health exam of $72.20 will be replaced with several different fees

For healthy patients, the fee for the annual health exam of $72.20 will be replaced with 
several different fees for the personal health visit. The new fees will be:
o Age 2 to 11:$41.60
o Age 12 to 17:$77.20
o Age 18 to 64:$50.00
o Age 65 and over:$77.20

OHIP InfoBulletin #4585
Implementation of 2012 Physician Services Agreement – Amendments to the Schedule of 
Benefits for Physician Services – Effective January 1, 2012

The Cochrane Library: General Health Checks in Adults for Reducing Morbidity and Mortality 
from Disease

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