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Fact check: What medical tests did White House physician Dr. Kevin O’Connor report for Joe Biden in 2021 and 2022?
Executive Summary
Dr. Kevin O’Connor’s public letters and physician statements from 2021 through early 2024 describe routine and specialty evaluations for President Joe Biden that included a physical exam, a colonoscopy in 2021, detailed neurologic exams described as “extremely detailed,” and specialty consultations at Walter Reed covering optometry, dentistry, orthopedics and neurology; the White House physician also reported treatment for obstructive sleep apnea with PAP/CPAP and management of acid reflux and cardiovascular risk factors [1] [2] [3] [4]. Multiple reports emphasize that formal cognitive testing was not included in the reported exams cited by O’Connor in 2021–2024, and outside reporting and later analyses highlight this omission and call for standardized cognitive assessment for public officeholders [3] [5].
1. What Dr. O’Connor explicitly reported — routine exams and procedures that matter to the public
Dr. O’Connor’s public descriptions in November 2021 state that President Biden underwent a routine colonoscopy and a comprehensive physical; that imaging showed arthritis and age-typical spinal changes; and that Biden has a hiatal hernia causing reflux while abstaining from alcohol and tobacco and exercising regularly [1]. Subsequent letters and reporting in 2024 expanded the documented regimen to include specialty consultations from Walter Reed’s Presidential Specialty Consultants in optometry, dentistry, orthopedics and neurology, and noted ongoing management of obstructive sleep apnea with PAP therapy, plus additions to reflux medication and continued use of statin and anticoagulant therapy where applicable [2] [3]. These items reflect the types of procedural and consultative medical tests and therapies commonly reported in a White House physician’s summary.
2. The notable absence — no standardized cognitive test in the publicly reported exams
Multiple sources note that O’Connor’s 2021 letter and later communications did not report any formal cognitive assessment such as a standardized mental status exam; the White House stated doctors determined a cognitive exam was unnecessary for the 2024 physical, and reporting reiterated that no cognitive test was administered during that evaluation [3]. Academic review published in 2025 examined Biden’s medical history and reiterated that while O’Connor reported “extremely detailed neurologic exams” in 2021, 2023 and 2024, those reports did not include formal cognitive testing, and the study framed this omission as meaningful for evaluating dementia risk given Biden’s documented cerebrovascular history and sleep apnea [5].
3. COVID-19 and acute testing events in 2022 — what was reported and what was not
In July 2022, the public record includes President Biden’s positive COVID-19 test and treatment with the antiviral Paxlovid; Dr. O’Connor’s routine evaluations around that period did not foreground additional, novel testing in 2022 beyond COVID testing and typical clinical follow-up [6]. Reporting from 2022 and 2024 reiterates that O’Connor described a full medical evaluation and found Biden fit for duty while documenting specialty exams and neurologic assessments, but the contemporaneous accounts did not list a cognitive battery or psychometric testing as part of the 2021–2022 clinical record made public [7] [4]. This pattern shows clinical care elements were documented, while specific neurocognitive testing was not disclosed.
4. Divergent framings: reassuring neurologic exams versus calls for standardized testing
O’Connor’s language — describing “extremely detailed neurologic exams” as reassuring and reporting normal findings for stroke, MS, Parkinsonism and other major neurologic diagnoses — has been presented as clinical reassurance in official letters and media summaries [4]. Outside academic commentary and later analyses flagged by a 2025 law‑medicine article argue that absence of formal cognitive testing leaves questions unanswered, especially given Biden’s prior stroke history and conditions that raise cognitive risk; these commentators advocate standardized, objective cognitive evaluation overseen independently for public transparency [5]. The two framings reflect a tension between treating clinicians’ judgments in individual care and broader public or academic demands for standardized cognitive metrics.
5. Bottom line for the record: which tests were reported for 2021–2022 and what remains unreported
The public record assembled from O’Connor’s letters and related reporting documents a colonoscopy and comprehensive physical in 2021, ongoing specialty consultations, detailed neurologic exams described as reassuring, tests and treatment related to COVID-19 in 2022, and ongoing management of sleep apnea and reflux; these items constitute the core of what Dr. O’Connor reported for 2021–2022 [1] [6] [2]. What remains consistent across sources is that formal, standardized cognitive testing was not reported in those years; later academic scrutiny and media reporting highlight that omission as the central gap between clinical reporting and calls for independent cognitive screening for leaders [3] [5].