When George M. Gould, a prominent physician, first implored Americans to get an annual physical checkup, he made it poetic. “The ranchman has his annual round-up; the merchant his yearly account of stock and balancing of books; the machinist gives his engine a thorough going-over at regular intervals; every military organization has its reviews and inspections,” Gould noted in a speech before the American Medical Association. “[I]t is not so,” he opined, “concerning the one piece of mechanism that conditions all these things, and that is the most valuable of all earthly possessions—the human body.”
This was 1900, and life expectancy for all races and genders was under 50. People dropped dead of polio and smallpox. It seemed wise to get checked out regularly. Over the next century, annual checkups for all were further encouraged as a matter of war readiness and insurance cost reduction.
Recently, the idea that people with no complaints should see a doctor has taken a hit. A 2013 Danish study of 183,000 people found no difference in long-term health outcomes between people who went to the doctor annually and those who went only when they had an issue. Some physicians have scrapped the idea of a yearly physical for healthy adults under 50 with no anxiety-raising family medical histories of disease and instead recommend they go every few years.
Some prefer not even to do that. We asked few people who go years—or who have gone years—without scheduling an appointment with a general practitioner to explain what keeps them out of the waiting room.
Ingrid Rachel Pipes, 26, Pittsburgh
I believe in health at any size, which basically means that at any weight, someone can have general basic health. My numbers have never been “off.” I don’t have diabetes. I do have polycystic ovarian syndrome, which testing has shown has affected my thyroid, and doctors have refused to prescribe me the medication for my thyroid unless I lose weight, even though if my thyroid was working properly, I would lose weight.
I might have been 15 [when I was diagnosed with PCOS]. I know I was prime puberty years. I went to thyroid specialists and endocrinologists. There were lots of doctors. Weight loss was the only active “preventative medicine” they would offer. Every trip to the doctor’s office has come with a 15-plus-minute lecture about how, even though my numbers are good, I will die soon. Even though I’m healthy now, I will pay later in years of life for being obese. I’ve been “obese” since I was 12.
I used to go to doctors all the time, but they constantly failed me because, rather than treat my PCOS or thyroid, they asked my parents to send me to fat camp or start Weight Watchers — both of which I’ve done, but without medication, I’m just going to stay fat regardless.
Once it was up to me, I stopped going to a GP by choice. Whereas, when my parents were in charge of my health, the desire was to lose weight because the idea was that would help me feel better. And I have no desire to lose weight. I only have a desire to be healthy and feel good. Being fat hasn’t hurt my health. I eat right. I exercise. My hormones are a little off, but there is no cure for PCOS, so I’m managing.
For one of my [public relations] clients, I had to I interview around 100 doctors from [the] Allegheny Health Network [a Pittsburgh medical and hospital system]. Almost all of them talked about how they focus on weight loss as part of preventative care, without being prompted. They were being asked questions like, “What’s your approach to patient care?” and over 75 percent of them are saying “weight loss.” It’s in their training to see weight as a primary issue.
I think that any doctor will tell you their approach is to listen to the patient first. With fat people, doctors tend to see fatness before they ever listen. If I’m coming in for a routine OB/GYN appointment, I don’t need to be told to lose weight. If someone’s coming in worried about pain or illness, doctors should be treating that. Yes, for some patients, losing weight is what they want and what will make them feel better, but it’s certainly not the primary treatment plan for someone coming in for a rash or an ear infection, or even a cancer scare.”
Brian LaRue, 36 New York City
For all intents and purposes, my body behaves like that of a very healthy person. I sleep fine. My digestion is fine. I don't have chronic pain. I don't get headaches. I don't have asthma, all that stuff.
My first reaction to most pains and ailments, aside from colds, is to suspect I have a terminal condition. If I have a terminal condition, I don’t want to know how much time I have left. I once thought an ingrown hair was a tumor. I once thought a rash was a tumor. Whenever I [hit] the top of my skull really hard, I try to stay up through the night, because that's how [Dead Boys lead singer] Stiv Bators died, by going to sleep after getting a concussion. I find myself taking stock of my heartbeat very often throughout the day. A few days ago, I was worried about permanent damage to my knees after I was a little stiff for two days straight, but it turned out I was just sleeping weird.
I also worry [because] I don't have a full picture of what I'm genetically predisposed toward. My dad was adopted. I don't know anything about his family's medical history.
I’ve been to walk-in clinics twice in the last two years: once after catching my ankle in a revolving door, and once to get a script for antibiotics for a sinus infection. Those didn't give me full physicals, not by a long shot. They just checked my weight and blood pressure, and confirmed I have the early stages of hypertension, which is exactly what I don’t want to hear about.
Recently, [my girlfriend] told me I needed to make a doctor's appointment or she would dump me. I know she's joking, but I understand a joke like that comes from a real place. I booked an appointment for a checkup, originally meant for the first week of January. It got bumped back to March, because I'm new, and I was so relieved. I really don't want to go to this appointment in March, but I guess I have to force myself to face my fear.
I absolutely didn't want to know about my health five years ago. I was drinking too much, I was smoking cigarettes every day, and I was eating Top Ramen four or five meals per week. I did a lot of less-than-healthy things in my 20s, and I figured, as I did with my credit, “I’ll take care of it later.” Yeah, well, now it's later, and it's freaking me out.
I'd consider it one milestone on a road toward accounting for my past. Other milestones have been financial. Hell, there was a time when I didn't know how much credit card debt I was in.
Harold Sherrell, 34, Dallas, TX
Usually in my experience, I’ve never been that sick where I am dying—and if I am, it just goes away. I’m from Syracuse. I grew up wrestling, and you kind of grin and bear it. There are worse things than just having a sniffle or a cold. There’s been a couple of times where I’ve been pretty bad. I got the flu. Usually, if you take DayQuil and drink a lot of water, it just runs its course. That’s been my experience.
The last time I went to the doctor I was passing blood through my stool. That was a bit of a shock, so I was like, “I better go to the doctor for this one. That’s one you might want to get looked at.” And that was from just wear and tear on my body from wrestling. Then, before that, I think I got strep throat, my freshman year going into my sophomore year [of college] over the summer, and I got some antibiotics. Even with that, it took me about a week. I was like, “It will get better.” I was pounding Advils. I felt really dumb because [the antibiotics] cleared it up really quick.
I broke my finger back in college on a Friday. I snapped it wrestling and I thought, “Well, the on-campus officials are gone and I’ve got tape and ice.” On Monday, it still hurt, but I was like, “Oh, this isn’t that bad,” and it was during summer, so I was free to do whatever I wanted to do. Ten years on, my finger is crooked. My middle finger is crooked. Looking back, I should have done something but I was just like, “Eh, it’s not that bad. I’ll get around to it.”
I have work. Between my gig, travel, and hanging out with my buddies, going to the doctor isn’t high on the list of priorities. It just slips my mind [that] I haven’t been to the doctor in a while. I’ve had one [regular] doctor my whole life from when I was a kid, but at 10 or 12, I just stopped. I never really got sick. But I didn’t mind it. You get checked out. You get away from school. Honestly, it’d probably be worth it [now] just to have a day off of work. You get your physical and whatever and then you have the rest of the day. It’d probably be worth it for just that alone.
The process was never bad. I never disliked it. My mom is the medical field, actually. She’s in administration. I don’t think she knows [I haven’t gotten a physical in years]. If she’s like, “Have you been to the doctor’s recently?” I’ll just glaze over it. In the course of conversation, she’s more concerned about when I am going to get married, when she’s going to get more grandkids than if I’ve been to the doctor.
I think people should go to the doctor, obviously. I think it’s a boneheaded move for me not to. It’s just one of those deals where you get caught up in the day-to-day and that gets pushed to the backburner.
Samuel Holm, 41, Shelton, Connecticut
In my day-to-day life, I don’t think about it. I feel like I am in generally good health. It doesn’t cross my mind. At the same time, I make sure my kids get their checkups and have all their shots. For me, I’ve only gone when I have had to go to the emergency room.
Who really wants to go to the doctor and be told there is something wrong with you? At my age, I do have to think about this. My girlfriend hounds me about it. She goes to the doctor every time she starts to worry about stuff. She goes to her OB/GYN and will go if there’s something wrong with her eyes.
For me, it’s out of mind. It’s not the best way of thinking, but it is my reality, I guess. I try to live a healthy lifestyle, but I do worry about that wakeup call, where I go and get diagnosed with something that could have been treated and I’m just that much worse.
I did smoke, but I quit smoking. I play hockey. I try to eat right, not eat a ton of fatty foods. I drink three or four beers a day and I guess that’s not healthy, but I’m not fat, so to speak. I am my high school weight of 160 pounds and I try to do stuff, not be a coach potato.
I’m at the age where I am thinking about [scheduling a checkup]. I haven’t pulled the trigger on it. I know I am at the age where I’m at increased risk of prostate cancer.
I’d probably kick myself in the ass [if I was diagnosed with prostate cancer later]. I think I would probably take it head on, but I would think I was an idiot for not going earlier.
Megan Bugey, 40, Austin
At the company I work for, the way it works is that anything up to $5,000, you have to pay for out of pocket, so it comes in handy if you are in a coma or something. But just for a general visit, it’s not really worth it. So if I have a cold, I just take over-the-counter medicine, rather than go to the doctor and shell out $100 [to] $150. But I got married in November and now I’m under my husband’s insurance. I guess I probably should go now.
We have pretty good genes in our family, longevity-wise. My grandparents all lived to be in their 90s, so I’m like, “Well, they were okay, so I guess I’m okay.” We don’t have a history of cancer or anything like that.
I think if I did go in for a physical, they would just tell me everything is okay. I don’t get dizzy or anything. I think my blood pressure is okay. I know I don’t have high cholesterol because I eat pretty well. The only thing that might be an issue is that we do have diabetes in our family, but I don’t really show any of those symptoms.
I think I would have to be really sick [to go to a doctor]—like, I can’t get out of bed. Or I have a 102-degree fever that won’t break, just horrible symptoms.
I just don’t like carving out time to go to the doctor. I’m a paralegal, so I have a pretty busy workload. It’s going to the doctor’s office: You have to take time off from work and then you get in there and you have to wait more and then you are there for three hours. For my job, we have to put in for any time that we’re going to miss, even if it’s an extended lunch hour, and that’s a huge hassle. So I’m like, “I’d rather take some NyQuil and be done with it.”
L.J. Moore, 35, Los Angeles
I didn’t have health insurance for a while because I was freelancing. Even when I had health insurance, I was doing okay and I didn’t want to spend the money on it because for all of what health insurance does, it’s still pretty expensive to go to the doctor. The other thing is a mental block where I think of the healthcare-industrial complex as a counterpart to the prison system, in that once you get in you can’t get out and I have been loath to get into the system. I really don’t trust American healthcare for the most part.
Whenever, I’ve come to the doctor in the last two years, it’s either been to urgent care or Planned Parenthood and that’s it. I went to urgent care this weekend because I had an asthma attack. I have asthma and I have not had an inhaler in ten years, because I let the prescription lapse and then I didn’t go to the doctor! I told them I barely take any meds. I take a Zyrtec when I am having an allergic reaction and I think they were shocked.
Everyone I know who sees a general practitioner is on some kind of medication and I don’t like taking a lot of drugs unless I’m really sick. I’m afraid they would ask me a lot of questions and then I would be on prescription meds for the rest of my life.
I’ve had some bad experiences when I did go to the doctor when I was younger. It made me distrustful of how I’d be treated. When I was a teenager, I got an STD from a guy when went down on me. This was in the state of Georgia, and they treated me like I was this little whore. There was so much judgement when they were asking me about my sexual activity and what I was doing with myself. That sucked. And I had a doctor who wouldn’t put me on birth control. It really undermined my faith if doctors exist to care for people or if they just exist to do things to people to make them money.
If we had socialized healthcare, I would go to the doctor just whenever, because I feel like it would take away the question about whether or not I was a product. I feel like it is impossible to engage with the medical community as it exists within the United States without the patient being a product, and I am not interested in participating in that.
Calvin Johnson, 32, New Orleans
I went to urgent care like three years ago when I had strep throat. I had to. I couldn't swallow.
I never go otherwise, because first off, they just always got something bad to tell you. You don't ever go to the doctor and they're like, "Oh my goodness, we just ran your test results and we just added five years to your life!" It's always like, "We just ran your test results now take this medicine which might fuck you up even more and hopefully you'll live." Get away from me with all that.
Then it's just a waste of money. I already know I'm going to die. I don't need to pay you money to tell me when I'm going to die. That's part of life. Part of life is not knowing when you're going to die. Why would I want to pay somebody to tell me when my demise is coming?
I don't have insurance. To be honest with you I don't even know if I'd go [to the doctor] if I had insurance because I've never had it. I left my parents' house when I was 18 and that's the last time I had insurance so that's the last time I've had a check up, a primary care doctor, a dental exam or anything like that. And when I went back then, it didn't bother me but I didn't see any benefit in it either. Every time you went you ended up in an uncomfortable-ass situation. Don't even get me started on the racial dynamics that exist when you go to the doctor.
Especially when you're talking about a conservative city like New Orleans, and you have to go see a specialist for whatever, and all you're dealing with is the old racist doctor who has no bedside manner as he or she talks to you, even refusing to look you in the eye. And you're like, why am I paying this high ass co-pay again?
I went to go see a dermatologist once, who was a white, and what was perplexing to me was how he could talk to me about [my skin]. He was highly recommended and he was about my age. I was looking at him like, you can't possibly talk to me about my skin. You're not an expert on that. You're not what I'm looking for.
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