Skip to main content

The Question

My doctor charges $125 for my annual checkup. I have no health problems. Does she have to charge this fee or is it at her discretion? Is this even legal in British Columbia?

The Answer

Story continues below advertisement

The value of the annual physical has sparked considerable debate in the medical community. It seems silly to test reflexes and listen to chests of healthy patients. But without one, some argue, those at risk for cancer and other diseases may be missed.

"There is no good evidence that a screening annual health examination improves people's health," said Danielle Martin, board chair of Canadian Doctors for Medicare, and a family physician at Women's College Hospital in Toronto. "Most engage in this practice but there's no medical evidence to support it."

Still, she does see some value in it. They are a good way to remind patients they require a mammogram or to test for blood glucose – something that is difficult during a shorter appointment. Having a physical every year, however, may be overdoing it.

Annual physicals on patients with no symptoms are covered in Alberta, Manitoba, Saskatchewan, Quebec, Prince Edward Island, Ontario and the Northwest Territories. Nunavut funds them for kids under 10 and adults 65 and older; the Yukon pays for a "well-woman" checkup (which typically includes a pap smear and breast exam). New Brunswick, Newfoundland and Nova Scotia do not cover them in symptomless patients.

In British Columbia, unless the doctor has a reason for doing the examination, it's not considered medically necessary, according to Ryan Jabs, the B.C. health ministry spokesman, who says it's been that way for a long time. So yes, it is legal for your doctor to bill you for the physical. If she didn't bill you for the service, she wouldn't be paid.

I do see why governments would want to scrap the annual physical – it costs boatloads of money and does not deliver measurable health benefits. Doctors in Ontario are paid $77.20 for the visit, which typically lasts about 25 minutes.

"It's outdated to have a review of every system of the body," said Cleo Mavriplis, an assistant professor of family medicine at University of Ottawa. "Examining someone when they are healthy is very low yield."

Story continues below advertisement

Young, healthy men, she pointed out, need blood-pressure checks and preventive counselling for sexually transmitted diseases – but not every year. Young women require pap smears; those in childbearing years require counselling to take folic acid.

Replacing the annual physical with a preventive health exam makes a lot of sense. Such an exam, done every year or two in older patients – less in younger patients – could catch those who require screening, including mammograms, cholesterol and colonoscopies.

It would also give doctors a chance to counsel patients on exercise and healthy eating, instead of performing useless exams on healthy bodies.

The Patient Navigator is a column that answers reader questions on how to navigate our health-care system. Send your questions to patient@globeandmail.com.

Report an error Editorial code of conduct
Due to technical reasons, we have temporarily removed commenting from our articles. We hope to have this fixed soon. Thank you for your patience. If you are looking to give feedback on our new site, please send it along to feedback@globeandmail.com. If you want to write a letter to the editor, please forward to letters@globeandmail.com.

Welcome to The Globe and Mail’s comment community. This is a space where subscribers can engage with each other and Globe staff. Non-subscribers can read and sort comments but will not be able to engage with them in any way. Click here to subscribe.

If you would like to write a letter to the editor, please forward it to letters@globeandmail.com. Readers can also interact with The Globe on Facebook and Twitter .

Welcome to The Globe and Mail’s comment community. This is a space where subscribers can engage with each other and Globe staff. Non-subscribers can read and sort comments but will not be able to engage with them in any way. Click here to subscribe.

If you would like to write a letter to the editor, please forward it to letters@globeandmail.com. Readers can also interact with The Globe on Facebook and Twitter .

Welcome to The Globe and Mail’s comment community. This is a space where subscribers can engage with each other and Globe staff.

We aim to create a safe and valuable space for discussion and debate. That means:

  • Treat others as you wish to be treated
  • Criticize ideas, not people
  • Stay on topic
  • Avoid the use of toxic and offensive language
  • Flag bad behaviour

Comments that violate our community guidelines will be removed.

Read our community guidelines here

Discussion loading ...

Cannabis pro newsletter
To view this site properly, enable cookies in your browser. Read our privacy policy to learn more.
How to enable cookies