HEALTH CHECKS

New Zealand Listener, Volume 37, Issue 952, 8 November 1957, Page 18

HEALTH CHECKS

aera ili This is the text of a talk on health broadcast recently from ZB, ZA, YA and YZ stations of the NZBS

by DR

H. B.

TURBOTT

Deputy-

Director-General of Health

| AM frequently asked why annual health examinations, often suggested as @ means of avoiding illness, are not put in the forefront of New Zealand’s health programme. I am often told by individuals who have gone to their own doctor for a periodic check over, how disappointed they were with the cursory nature of the doctor’s examination, often just a quick physical examination and a hearty assurance that there is nothing to worry about. Our doctors, in general, are so busy dealing with sickness, and with large numbers of people whose ills are really of the mind and emotions and from unhappiness, that they really haven’t the time to give to worthwhile periodic health examinations. They can hardly help this, for you, the people, cast your Health Benefits under Social Security in a curative rather than a preventive mould. You wanted, and legislated for, a scheme that looked after you in every possible way when you were sick. You have that. Your doctors are completely caught up: in fulfilling the scheme’s requirements, and it doesn’t seem possible to me that they can go on doing this, and undertake as well proper health examinations, estimated from experience overseas, to require a minimum of one hour per person. To be of any value what does an annual or periodic health examination involve? Such a routine physical checkup, to be significant, involves a careful enquiry into the story of one’s health, diet, living habits, a complete physical examination, laboratory tests, a chest x-ray, tests of vision and hearing, and if over 40, an electro-cardiograph, and such further special testing as the examination may indicate as being necessary. Now you know what your Social Security Scheme is costing you already as a taxpayer. Supposing your doctors could do these periodic examinations, the multiple laboratory, x-ray, and other specific tests, are very expensive things, and the cost of your Health Benefits would soar until it really hurt your pocket. Nevertheless, I personally would have the greatest of pleasure if this type of work were possible under our scheme, because it would detect some hidden disease, diagnose other disease early at a time when arrest may be possible, and enable a review of health and dietary habits that would probably not only lengthen but also make life more enjoyable. No country, as far as I am aware, has managed to produce this ideal

arrangement whereby citizens have an annual health examination. In U.S.A. they used to advise periodic health examinations, but have found it is only a partial solution because few doctors give the hour examination required. If a skimpy check up is done, many conditions are overlooked, and even in U.S.A. there are insufficient physicians to enable a full hour examination for everybody. So they have developed what they call "multiphasic health screening" for selected population groups. An example is an industrial unit for screening workers, with a staff of two nurses, two receptionists, two laboratory technicians, one x-ray technician, and three doctors. In an eighthour working day such a unit gives 5060 workers a complete health examination, each ‘examination keeping the worker off the job from 45-60 minutes. The examinee is referred to his personal doctor for treatment or follow up examinations. as required. You can’t do these health examinations without laboratory aid or certain special procedures. Experience shows that about 13% of all defects requiring treatment are discovered purely on the basis of such laboratory and ‘special tests. In the remaining 87% the laboratory supports the diagnosis made clinically, These mass screening surveys are developing in U.S.A. to overcome the inability of the medical profession to give periodical health examinations to all comers. They are not all complete in the coverage offered, as in the industrial unit already described. But they do search for several diseases at the same time, usually, tuberculosis, syphilis, certain types of heart disease, diabetes, anaemia, eye and ear defects, and obesity. Sometimes cell tests for uterine or lung cancer are offered. Such multiphasic health screening does detect early significant disease in large population groups. In our own country the nearest approach we have to such procedures is in our mass x-ray surveys. These reveal also certain heart troubles, some lung cancers, and hydatid cysts occasionally, and have proved their worth in the detection of hidden disease. The Board of Health has been reconstituted recently, and has set up a committee to make suggestions regarding outpatient services in hospitals. It may be that, through this avenue, there will be developed the possibility of the periodic health examination.