Let’s Put an End to Annual Physicals

The doctor looked in my ears, shined a light in my eyes and mouth, and listened to my heart and lungs with his stethoscope, before ending the exam with this: “Turn your head and cough, sir.” I did what I was told, but the whole experience felt absurd. This wasn’t a physical I’d scheduled or wanted. And the last time any doctor had asked me to turn my head and cough—a hernia exam—Nixon was president and I was 12, in my skivvies along with 30 other boys, lined up in a cold Michigan gymnasium, getting cleared for basketball.

The exam was required because the hospital, where I’ve worked as an emergency room physician for 30 years, had just acquired my physician group. I and 100 colleagues were technically new employees, necessitating pre-employment physicals. It didn’t matter we are in the middle of a pandemic.

I’d have probably let the whole thing roll off my back. But I had a shift in the emergency room later that day, and I couldn’t avoid playing it back as I saw my first patient, a 40-year-old who probably had Covid-19, complaining of a cough and a low-grade fever. She didn’t get a physical exam, nor did any of the dozen “likely Covid-19” patients I saw that evening.

We had to speak just below a yell to overcome our physical distance and the constant din of the portable air-filtering machines. As I listened to her story, my focus turned to her breathing. What was her respiratory rate? How many words could she get out before needing a breath? She coughed occasionally but her oxygen saturation showed 94 percent; not normal, but adequate. The fact that her voice sounded strong and her breathing unlabored, especially through the mask and noise, told me she wasn’t sick enough to require hospitalization. I explained how to self-isolate, how to spot more serious symptoms, printed up her paperwork, and discharged her home.

What I realized the next day was that, thanks to Covid-19, this h