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Annual exams vs. annual wellness visits — 7 Comments

  1. Despite the fact that insurance pays, why even attempt to have a PCP relationship when it is nothing but a q&a. Since when do doctors let alone their nurse practitioners feel it is so important to ask if you wear your seat belt, have smoke detectors or own guns rather than how have you been feeling? What was shocking is that simple maintenance drugs are only issued for 6 months and then another appt is necessary.

    I’m so glad that I opted to developers my healthcare relationships with specialists. Same price, longer appt but you don’t get the feeling that you are a revenue stream.

  2. I have an ARNP as my PCP. This is the first time I have had the office call me twice to schedule my “wellness exam”. It will not be w/my PCP, it will be with the Medical Assistant. Is this typical? Thanks! Dg

    • Hi Daphne, thanks for your comment. Different health organizations have different policies, but yes, it is becoming more typical that lower-level providers cover the wellness visits. Because these exams are basically about plugging people into age and gender appropriate screening tests, it’s not considered worth the physician’s (or ARNP apparently) time. Also, the insurance company reimburses the same, which is another disincentive to waste a physician’s time.

      I don’t like this trend. I think too many unnecessary screening tests are being done and we should be able to have an informed discussion with our chosen health care provider about which tests we really need–a need based on more than just our age and gender. I don’t believe a lower-level provider, like a medical assistant, will have the education or experience to do this.

      You could ask to see your ARNP for the wellness visit instead of the MA, but you might then be charged for an office visit. But it doesn’t hurt to ask. Good luck! FN

  3. Is there any data to support the new regulations? Would it not be more expensive and inefficient to revisit a doctor multiple times to mention different concerns? I would think that the paperwork alone would be prohibitively expensive. The one visit, one problem rule seems to be a frustrating barrier to getting decent care from a doctor. Most people are challenged enough to get to a doctor once, much less multiple times within a year.

    • Hi Nathan, thanks for the comment. Well, I think you hit on the head one of the many reasons health care is so expensive–the administrative costs are massive. One of the driving factors behind the one visit, one problem rule, I believe, is electronic health and billing records. Reimbursement is maximized when one diagnosis code (rather than several) is paired with one procedure code. I agree with you that it’s not an efficient use of time or money, at least for the patient! Cheers, FN

  4. You have accurately described many people’s situation. My doctor and clinic have changed the name to “wellness visits,” but I’m still receiving the same annual exam, during which I bring up other stuff I’ve been saving up to tell the doctor about to see if he thinks it is important for some reason. There are more questions, as you mention, almost all of which are irrelevant to me I’m happy to say.

    My annual wellness visit is coming up soon. I keep wondering every year whether I will experience the change to what you have described. I know people who have. Others have posted pictures on social media of signs in doctors’ offices announcing the institution of a one visit, one problem rule.

    • Hi Ray, always nice to hear from you! If you have a long-standing relationship with a doctor, it’s more likely he or she will spend more time with you. The patient-doctor relationship really makes a difference. Unfortunately, more of us (myself included) have had to change our doctors because of our insurance networks, and our new doctors are less likely to take the extra time out of their already crazy clinical schedules.

      There has also been a lot of confusion among both physicians and patients about what these “wellness” visits entail. More medical practices are standardizing these visits to only meet the minimum federal requirements of data gathering and screening guidelines. Under it’s coding definition, Medicare’s Annual Wellness Visit or AWV can take no longer than 20 minutes, although I’m not really sure how they can police that.

      Have a healthy 2016! FN