A doctor using a stethoscope to listen to a 15-month-old's abdomen Routine The routine<unk> , also known as general medical examination,<unk> riodic health evaluation, annual<unk> , comprehensive medical exam, general health check, preventive health examination, medical check-up, or simply medical, is a<unk> <unk> rformed on an asymptomatic patient for medical screening purposes. These are normally<unk> rformed by a<unk> diatrician, family practice physician, physician assistant, a certified nurse practitioner or other primary care provider. This routine<unk>  exam usually includes the HEENT evaluation. Nursing professionals such as Registered Nurse, Licensed Practical Nurses can develop a baseline assessment to identify normal versus abnormal findings. These are reported to the primary care provider. If necessary, the patient may be sent to a medical specialist for further, more detailed examinations. The term is generally not meant to include visits for the purpose of newborn checks, Pap smears for cervical cancer, or regular visits for<unk> ople with certain chronic medical disorders (for example, diabetes). The general medical examination generally involves a medical history, a (brief or complete)<unk>  and sometimes laboratory tests. Some more advanced tests include ultrasound and mammography. If done for a group of<unk> ople the routine<unk>  is a form of screening, as the aim of the examination is to detect early signs of diseases to prevent them. Evidence Although annual medical examinations are a routine practice in several countries, unspecified examinations are poorly supported by scientific evidence in the majority of the population. A Cochrane Collaboration meta-study found that routine annual<unk> s did not measurably reduce the risk of illness or death, and conversely, could lead to overdiagnosis and over-treatment; however, this article does not conclude that being in regular communication with a doctor is not important, simply that an actual<unk>  may not be necessary. Some notable general health organisations recommend against annual examinations, and propose a frequency adapted to age and previous examination results (risk factors). The specialist American Cancer Society recommends a cancer-related health check-up annually in men and women older than 40, and every three years for those older than 20. A systematic review of studies until September 2006 concluded that the examination does result in better delivery of some other screening interventions (such as Pap smears, cholesterol screening, and faecal occult blood tests) and less patient worry. Evidence supports several of these individual screening interventions. The effects of annual check-ups on overall costs, patient disability and mortality, disease detection, and intermediate end points such a blood pressure or cholesterol, are inconclusive. A recent study found that the examination is associated with increased participation in cancer screening. Some employers require a mandatory health checkup before hiring a candidate, even though it is now well known that some of the components of the prophylactic annual visit may actually cause harm. For example, lab tests and exams that are<unk> rformed on healthy patients (as opposed to<unk> ople with symptoms or known illnesses) are statistically more likely to be "false positives” — that is, when test results suggest a problem that does not exist. Disadvantages cited include the time and money that could be saved by targeted screening (health economics argument), increased anxiety over health risks (medicalisation), overdiagnosis, wrong diagnosis (for example Athletic heart syndrome misdiagnosed as Hypertrophic cardiomyopathy) and harm, or even death, resulting from unnecessary testing to detect or confirm, often non-existent, medical problems or while<unk> rforming routine procedures as a followup after screening. A resident physician at the Granada Relocation Center, examining a patient's throat The lack of good evidence contrasts with population surveys showing that the general public is fond of these examinations, especially when they are free of charge. Despite guidelines recommending against routine annual examinations, many family physicians<unk> rform them. A fee-for-service healthcare system has been suggested to promote this practice. An alternative would be to tailor the screening interval to the age, sex, medical conditions and risk factors of each patient. This means choosing between a wide variety of tests. Prevalence The routine<unk>  is commonly<unk> rformed in the United States and Japan, whereas the practice varies among South East Asia and mainland European countries. In Japan it is required by law for regular working employees to check once a year, with a much more thorough battery of tests than other countries. History The roots of the<unk> riodic medical examination are not entirely clear. They seem to have been advocated since the 1920s. Some authors point to pleads from the 19th and early 20th century for the early detection of diseases like tuberculosis, and<unk> riodic school health examinations. The advent of medical insurance and related commercial influences seems to have promoted the examination, whereas this practice has been subject to controversy in the age of evidence-based medicine. Several studies have been<unk> rformed before current evidence-based recommendation for screening were formulated, limiting the applicability of these studies to current-day practice. Comprehensive Comprehensive<unk>  exams, also known as executive<unk> s, typically include laboratory tests, chest x-rays, pulmonary function testing, audiograms, full body CAT scanning, EKGs, heart stress tests, vascular age tests, urinalysis, and mammograms or prostate exams depending on gender. Pre-employment Pre-employment examinations are screening tests which judge the suitability of a worker for hire based on the results of their<unk> . This is also called pre-employment medical clearance. Many employers believe that by only hiring workers whose<unk>  results pass certain exclusionary criteria, their employees collectively will have fewer absences due to sickness, fewer workplace injuries, and less occupational disease. A small amount of low-quality evidence in medical research supports this idea. Furthermore, the cost of staff health insurance will be lower. However, certain exams or tests that are requested by employers, such as a baseline low back x-ray, should not be<unk> rformed, according to the American College of Occupational and Environmental Medicine. Reasons for this include the legality and medical necessity of the test as well as the inability of such testing to predict future problems, the radiation exposure to the worker, and the cost of the exam. Insurance A<unk>  may be provided under health insurance cover, required of new insurance customers. This is a part of insurance medicine. In the United States,<unk> s are also marketed to patients as a one-stop health review, avoiding the inconvenience of attending multiple appointments with different healthcare providers.
Physical examination
Pelvic examination
Anthropometry
Neurological examination
Cardiovascular examination
Blood test
Cardiac examination
Respiratory examination