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Checkups For You, Checkmarks For Your Doctor

My car was making a chirping noise when I drove forward and a high-pitched whine when I went in reverse, so I took it into the mechanic and, while he’s under the hood, for some long-deferred routine maintenance (an oil change).

So when the phone rang, I was expecting him to tell me I need new brakes. Nope, it’s the pharmacy, which can’t refill a prescription. I have to see the doctor in person. I’m not sick, but I’d deferred my routine maintenance for too long. In this case, because I’m on a maintenance drug, he needs to check my blood pressure (which by this point was rising).

The insurance company audits the doctor, and publishes physician ratings based on his charts. I’m a checkmark against him if don’t get checkups while on a maintenance drug. I asked him how he felt about my being there for the insurance company.

“I’m not a doctor, I’m a provider of medical services.”

Don’t take this the wrong way. My doct … er, medical service provider wants to see me more often than I come in. But working in the background are the insurance companies who give him an annual exam, or in the case of one, a checkup three times a year. They pull his charts to make sure that patients are getting the care that the insurance company wants them to get. Women need to have proof of an annual OB/GYN exam, and the OB/GYNs rarely copy him on the visits. That’s a checkmark against my doct … er, medical service provider. If too many people on his panel are obese, it’s a checkmark against him.

In my case, a routine physical exam for a 40-year-old man meant getting weight, blood pressure, an EKG (baseline only, in case there’s ever a problem) and a blood exam (the works). Then, I could get my prescription filled.

The hero of the story is actually Ron, my mechanic. I needed new front brakes and that long-deferred maintenance. I wonder how long before my car insurance starts to enforce oil changes?

*This blog post was originally published at ACP Internist*

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