Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Here’s an easy way for Medicare to save money

Skeptical Scalpel, MD
Physician
August 14, 2014
Share
Tweet
Share

You may find this story hard to believe, but it’s true.

A 75-year-old non-smoking man with no serious medical problems and a relatively low-risk family history (father, a life-long smoker, died of a stroke at age 76) has been undergoing routine physical examinations by his primary care physician in Florida every 6 months for several years.

The visits include a full battery of laboratory studies, nearly all of which have been completely normal on every occasion.

The patient told me that he has been on a statin for about 20 years. At the time it was started, his total cholesterol level was 201 mg/dL. The generally accepted upper limit of normal is 200 mg/dL.

After his last visit, the doctor told him to take his pill every other day because his most recent total cholesterol was 109 mg/dL.

Can hypocholesterolemia cause health problems? How low is too low? No one knows for sure, but cholesterol is a constituent of cell membranes and many hormones.

I’ve blogged before about the overuse of medical care; particularly Pap smears in Florida.

Why does Medicare pay for all these unnecessary tests and drugs? Medicare probably has no way of knowing that a statin was started and is being continued for no good reason. But what about the cost of the office visits and routine blood work every 6 months?

It’s probably not much money per person, but of all the states, Florida has the greatest proportion of people who are at least 65 years old (17.3% in 2012).

The population of Florida in 2012 was 19.32 million so it has 3.28 million people over the age of 65. There’s potential for a lot of money to be wasted.

As one of its Choosing Wisely items, the Society of General Internal Medicine has recommended that routine general health exams not be done for asymptomatic adults.

A Cochrane Review of 14 studies comprising 182,880 patients came to the same conclusion and noted that important harmful outcomes of routine check-ups were often not studied or reported.

In June I wrote about the doctors who received seemingly excessive Medicare payments identified by various journalists and wondered why Medicare couldn’t have discovered these obvious outliers on its own.

ADVERTISEMENT

Routine check-ups every 6 months seem easy enough to identify and squelch. Why can’t Medicare do something?

“Skeptical Scalpel” is a surgeon blogs at his self-titled site, Skeptical Scalpel.

Prev

Drop doctorspeak and get real with patients

August 14, 2014 Kevin 62
…
Next

Interdependent physician practice is here to stay

August 14, 2014 Kevin 0
…

Tagged as: Primary Care

Post navigation

< Previous Post
Drop doctorspeak and get real with patients
Next Post >
Interdependent physician practice is here to stay

ADVERTISEMENT

More by Skeptical Scalpel, MD

  • The hospital CEO who made a surgical incision. What happened?

    Skeptical Scalpel, MD
  • Medical error is not the third leading cause of death

    Skeptical Scalpel, MD
  • Should speed-eating contests be banned?

    Skeptical Scalpel, MD

More in Physician

  • The hidden costs of the physician non-clinical career transition

    Carlos N. Hernandez-Torres, MD
  • The poet who changed my DNA

    Ryan McCarthy, MD
  • Why the real flex in life is freedom of time and self

    Preyasha Tuladhar, MD
  • Clinical attachment in medicine: How familiarity creates safety

    Nesrin Abu Ata, MD
  • Why clinical excellence isn’t enough to sustain a physician-owned hospital

    Dr. Bhavin P. Vadodariya
  • Leading with love: a physician’s guide to clarity and compassion

    Jessie Mahoney, MD
  • Most Popular

  • Past Week

    • Alex Pretti: a physician’s open letter defending his legacy

      Mousson Berrouet, DO | Physician
    • The elephant in the room: Why physician burnout is a relationship problem

      Tomi Mitchell, MD | Physician
    • ADHD and cannabis use: Navigating the diagnostic challenge

      Farid Sabet-Sharghi, MD | Conditions
    • Why private equity is betting on employer DPC over retail

      Dana Y. Lujan, MBA | Policy
    • Leading with love: a physician’s guide to clarity and compassion

      Jessie Mahoney, MD | Physician
    • The hidden costs of the physician non-clinical career transition

      Carlos N. Hernandez-Torres, MD | Physician
  • Past 6 Months

    • Physician on-call compensation: the unpaid labor driving burnout

      Corinne Sundar Rao, MD | Physician
    • How environmental justice and health disparities connect to climate change

      Kaitlynn Esemaya, Alexis Thompson, Annique McLune, and Anamaria Ancheta | Policy
    • Will AI replace primary care physicians?

      P. Dileep Kumar, MD, MBA | Tech
    • A physician father on the Dobbs decision and reproductive rights

      Travis Walker, MD, MPH | Physician
    • What is the minority tax in medicine?

      Tharini Nagarkar and Maranda C. Ward, EdD, MPH | Education
    • Why the U.S. health care system is failing patients and physicians

      John C. Hagan III, MD | Policy
  • Recent Posts

    • The hidden costs of the physician non-clinical career transition

      Carlos N. Hernandez-Torres, MD | Physician
    • Invoking your rights is the only way to survive a federal investigation [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why almost nobody needs a PhD anymore: an educator’s perspective

      Richard A. Lawhern, PhD | Education
    • Health advice vs. medical advice: Why the difference matters

      Abd-Alrahman Taha | Education
    • Why private equity is betting on employer DPC over retail

      Dana Y. Lujan, MBA | Policy
    • From doctor to patient: a critical care physician’s ICU journey

      Ian Barbash, MD | Conditions

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 11 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Alex Pretti: a physician’s open letter defending his legacy

      Mousson Berrouet, DO | Physician
    • The elephant in the room: Why physician burnout is a relationship problem

      Tomi Mitchell, MD | Physician
    • ADHD and cannabis use: Navigating the diagnostic challenge

      Farid Sabet-Sharghi, MD | Conditions
    • Why private equity is betting on employer DPC over retail

      Dana Y. Lujan, MBA | Policy
    • Leading with love: a physician’s guide to clarity and compassion

      Jessie Mahoney, MD | Physician
    • The hidden costs of the physician non-clinical career transition

      Carlos N. Hernandez-Torres, MD | Physician
  • Past 6 Months

    • Physician on-call compensation: the unpaid labor driving burnout

      Corinne Sundar Rao, MD | Physician
    • How environmental justice and health disparities connect to climate change

      Kaitlynn Esemaya, Alexis Thompson, Annique McLune, and Anamaria Ancheta | Policy
    • Will AI replace primary care physicians?

      P. Dileep Kumar, MD, MBA | Tech
    • A physician father on the Dobbs decision and reproductive rights

      Travis Walker, MD, MPH | Physician
    • What is the minority tax in medicine?

      Tharini Nagarkar and Maranda C. Ward, EdD, MPH | Education
    • Why the U.S. health care system is failing patients and physicians

      John C. Hagan III, MD | Policy
  • Recent Posts

    • The hidden costs of the physician non-clinical career transition

      Carlos N. Hernandez-Torres, MD | Physician
    • Invoking your rights is the only way to survive a federal investigation [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why almost nobody needs a PhD anymore: an educator’s perspective

      Richard A. Lawhern, PhD | Education
    • Health advice vs. medical advice: Why the difference matters

      Abd-Alrahman Taha | Education
    • Why private equity is betting on employer DPC over retail

      Dana Y. Lujan, MBA | Policy
    • From doctor to patient: a critical care physician’s ICU journey

      Ian Barbash, MD | Conditions

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Here’s an easy way for Medicare to save money
11 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...