 Physicians and patients have come to expect the annual checkup as a routine part of care. However, considerable research has not demonstrated to have any substantial benefits, and so a revolt is brewing against the tradition of periodic checkups. Even the Society for General Internal Medicine has advised primary care physicians to avoid such routine general health checks for asymptomatic adults. Checkups seem to make sense, because historically medical practice has included all sorts of things that seemed to make sense, such as hormone replacement therapy for menopause, until it was put to the test and found to increase the risk of breast cancer, blood clots, heart disease, and stroke. Or like when doctors killed babies by making the so-called common sense recommendation that infants sleep on their tummies, whereas we all know now face-up to wake up. We should always demand evidence. We check our cars regularly, though, so why shouldn't we also check our bodies? Well, unlike cars, our bodies have self-healing properties. To see if the benefits outweigh the harms, researchers decided to put it to the test. So what are the benefits and harms of general health checks for adult populations? The bottom line is that checkups were not associated with lower rates of mortality, meaning not associated with living longer or lower risk of dying from heart disease, stroke, or cancer. So general checkups may not reduce disease rates or death rates, but they do increase the number of new diagnoses. And the harmful effects of the tests and subsequent treatments could have balanced out any benefits. Possible harms from checkups include overdiagnosis, over-treatment, distress or injury from invasive follow-up tests, distress due to false positive test results, false reassurance due to false negative test results, possible continuation of adverse health behaviors due to negative test results, adverse psychosocial effects due to labeling and difficulties with getting insurance now that you have a pre-existing condition, not to mention all the associated costs. For example, diabetes. Wouldn't it be great if we picked up a case of diabetes earlier? Perhaps not if they were given the number one diabetes drug at the time, Avandia, which was pulled off the market because instead of helping people, it appeared to be killing people. Adverse drug events are now one of our leading causes of death. When it comes to lifestyle diseases like type 2 diabetes, maybe we should instead focus on creating healthier food environments, like my new favorite organization, Balanced, to help prevent the diabetes epidemic in the first place. How many times have you tried to inform someone about healthy eating, about evidence-based nutrition, only to have them come back and say, no, I don't have to worry, my doctor says I'm okay. I've just had a check-up, everything's normal, as if having a normal cholesterol is okay in a society where it's normal to drop dead of a heart attack to the number one killer of men and women. I mean, if you went to see a lifestyle medicine doctor who spent the check-up giving you the tools to prevent 80% of chronic disease, that's one thing. But given the way medicine is currently practiced, it's no wonder perhaps why the history of routine check-ups has been one of glorious failure. But generations of well-meaning clinicians just don't want to believe it. Policy should be based on evidence, though. Poor diet is on par with cigarette smoking. It's the most common actual cause of death. Yet the medical profession is inadequately trained in nutrition. Worse, nutrition education in medical school appears to be in decline, if you can believe it, a shrinking of nutrition education among health professionals. So the advice you get in your annual check-up may just be from whatever last tabloid your doctor skimmed in the checkout line. Screening opportunities should not be regarded as a form of health education, one medical journal editorial read. People who are obese know very well that they are, and we have no means of helping them, and we should just shut up. Well, if you really have nothing to say that will help them, you should shut up, especially doctors who say they have no idea what constitutes a healthy diet, though veggies and nuts are a good start.