The 'general check-up' in the asymptomatic adult - A study of GPs in the North West of Ireland

Background: The asymptomatic general check-up (AGCU) is a common consultation in primary care. Detractors of the AGCU cite a lack of evidence and the harm of over-investigation. Proponents cite the opportunity for the GP to engage in health promotion and explore hidden concerns of the patient. Objectives: To research Irish GP experiences with the AGCU, including their approach to the consultation and to assess their attitudes towards the AGCU. Methods: In 2013, a cross-sectional postal-survey of 136 GPs in the Northwest of Ireland was performed. This was a mixed-method study which underwent both quantitative and qualitative analysis. Results: The response rate was 79/136 (57%). Over 6% of reported consultations were for an AGCU. Large differences existed amongst GPs in their approach to the AGCU. Cardiovascular risk assessment and blood investigations were deemed the most important. GPs had concerns about the AGCU relating to patients being falsely reassured, about the workload and over-diagnosis. Still, 63% of responding GPs felt that the AGCU was clinically useful. Seventy per cent did not agree with private companies offering an AGCU. Conclusion: Despite the lack of evidence for its use and frustrations expressed by GPs, the AGCU is a frequent consultation. GPs took very different approaches to the consultation when a patient presented for a check-up. Most responding GPs think it can have some clinical benefit. There is a need for GPs to appropriately challenge mistaken health beliefs pertaining to the AGCU.