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Too much care, or just enough?

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Thanks for your excellent article [“Let’s Get Less Physical,” Feb. 13] on the ridiculous habit of the annual physical.

How can we order all of these unnecessary tests without any proven benefit while we at the same time have 45 million uninsured Americans?

The people who get and insist on these annual physicals are those who are the healthiest and most educated and that benefit the least from any kind of random testing, while those who are uninsured are often the sickest, but they can’t even get a pap smear done!

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U.S. health care is a disaster in the making.

DR. MIKAEL BRISINGER

West Los Angeles

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While I agree that the non-targeted annual physical is almost worthless, one organ system usually neglected during the annual exam should, in fact, be examined yearly for some people: the skin. Over many years as a dermatologist, I have diagnosed hundreds of skin cancers, including melanomas, that were not detected by the patient’s primary care physician.

Those people with a history of skin cancer or excessive sun exposure with signs of sun damage should have a skin screening exam at intervals deemed appropriate by a dermatologist.

DR. FRANCES SEGAL

Laguna Niguel

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I was disturbed by this article, which I felt was irresponsible and could lead people to abandon a checkup that can be lifesaving and life-enhancing. The annual physical and the tests included go a long way to keeping us healthy.

Without disclosing my own health matters, I will say that the physical has discovered conditions requiring medication and follow-up; the same is true for numerous friends. And I also know that friends who haven’t had the annual [physical] wound up with untreated conditions that are life-threatening.

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To say the yearly physical is unnecessary based on the little authority in your article is irresponsible and dangerous. It sounds like the L.A. Times is working for the insurance companies that don’t want to pay for these.

Finally, it has taken doctors years to get patients to have checkups; you are undermining what they have achieved. Isn’t it the personal physician in consult with the patient who should decide these matters? And not the L.A. Times?

GERALDINE DART

Santa Monica

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Letters should be brief and must include the writer’s name, address and phone numbers. Internet writers also must include name, street address and telephone numbers. Letters are subject to editing and condensation. Mention date of publication when referring to a specific article. Mail to Letters in Health, Los Angeles Times, 202 W. 1st St., Los Angeles, CA 90012; e-mail to health@latimes .com; or fax to (213) 237-4712.

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