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Arch Intern Med. 1999;159:909-910.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

MY HMO allows me a complete physical exam every year, so I might as well get one."

Sound familiar? How often do we perform annual complete physical examinations (CPEs) on otherwise healthy, asymptomatic people? If the need for these examinations is not supported by the literature, they can be seen as clinical time taken away from otherwise needy patients.

Cost escalation in health care is well documented. The last decade has seen a rise in managed care as an answer to this problem. Managed care organizations (MCOs) have promised care at reduced cost. However, based on the above scenario, it appears they may be promoting care that is sound from a business perspective (also called marketing), at the expense of that which is also scientifically sound based on the medical literature.

In Tucson, Ariz, where we have a stage 4 managed care penetration, these visits are challenging to us. If . . . [Full Text of this Article]

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