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Think you need a check-up? Consider how fit and healthy you are before rushing off to your doctor as it could lead to extra worries.

At the start of each appointment in my clinic, after the usual greetings and pleasantries about the weather, I ask something along the lines of "So what can I do for you today?"

There are several iterations of this, depending on how well I know the patient, but I choose these words in the knowledge that often a patient has come with something specific in mind, not just because they are feeling unwell.

Answers to my question vary –  many times people simply need repeat prescriptions, or have follow-up discussions about tests we have ordered; sometimes they are there to talk about worries, either concerning them or a loved one; and sometimes it is because they are unwell.

Not infrequently though the answer will be, "I'm fine – I just thought it was time for a check-up".

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This amazes me – in general it isn't something I would ever think to do for myself or my family and I am impressed by people's organisational skills to be able to think ahead and book appointments "just because".

Whether or not routine check-ups (ie, a doctors' appointment when you are well) are a good thing however is up for debate. Yes, it is undoubtedly admirable to be thinking about your health and wellbeing, even when you don't have any worrying symptoms at all, and hopefully you will leave the appointment with some good advice about how to ensure you stay well for as long as possible. However, check-ups can lead to unnecessary testing without any good scientific evidence that says this kind of testing actually works – especially if the testing itself creates undue worry, stress or potential false results.

Having said that, there are times in life when check-ups are definitely warranted, including:

* Early childhood when they are an important opportunity to screen for developmental or physical health issues that may not be immediately obvious

* During pregnancy and for the first few weeks after the birth

* If you have any type of chronic (ie, ongoing) health condition – this includes diseases such as asthma, heart problems, diabetes, epilepsy, arthritis, depression and many more. Check-ups enable a doctor to re-assess whether you are on the right, most up-to-date, treatment, at the correct dose, and that no other testing or management is needed, even if you feel completely well and symptom-free

* If you are due routine screening checks such as breast screening (from 45), smear tests (from 20), cardiovascular risk checks (from 40 upwards, depending on your risk), prostate checks and so on

* If you are on regular contraception or have a change in partner and need a sexual health check.

At other times in life, if you are thinking of booking a "check-up", I would suggest you are guided by firstly how fit and healthy you are - if you smoke, drink too much, are overweight or have a family history that suggests you are at risk of particular health issues, then you should be seeing a doctor regularly to try to modify your risk factors. Secondly, think about your age – as we get older our risk of developing "silent" conditions such as high blood pressure, glaucoma or diabetes increases. Seeing your doctor or nurse regularly if you are over 60 (or younger if you are Māori or Pacifica) will ensure you pick up any developing health issues early on, before they cause too many complications.

Lastly, if you do decide to book a "check-up", don't go with fixed expectations – your doctor will ask questions and talk to you first to assess any specific risks you may have, and will be guided by this before deciding to do any tests or further assessments. Hopefully, you will leave with a reassuring clean bill of health.

* Dr Cathy Stephenson is a GP and mother of three.

 - Stuff