The annual physical examination remains a popular format with both patients and providers, despite the lack of evidence that either a comprehensive examination or laboratory screening tests are indicated for healthy adults. Patient desire for extensive testing and comprehensive examination combined with provider belief that the physical examination is both of proven value and can detect subclinical illness have led to the continued pervasive practice of annual physical examinations in our country. The authors review the current forces behind the ongoing popularity of the annual physical examination and the current recommendations for preventive services in healthy adults, and provide thoughts on what the busy practicing clinician can focus on in the realm of proven preventive health.