A fee-for-service system will inevitably lead some physicians to “create” more visits. After all, more visits = more revenue. Advising a yearly routine colonoscopy however, such as in this case, is crossing the line.

That being said, routine visits do have a place. For instance, I routinely see all my hypertensives and diabetics every 3-6 months (depending on their severity). That’s not churning, it’s just good medicine.

Old-timer Dr. Gott isn’t happy with what he sees:

I remember starting my practice 40 years ago, when people sought medical attention for specific complaints – or, if over 65 years of age, an annual examination. The medical culture has changed, and not necessarily for the better.