Since most of my practice is not managed care but fee for service, I still have the liberty of performing annual examinations for patients when indicated. I have found this beneficial to the doctor-patient relationship as well as for occasionally uncovering important medical disease before symptoms are bad enough for the patient to seek my attention.
Drs Gordon et al1 discuss patient care from a monetary viewpoint. This seems to be a clear declaration that managed care promotes policies designed to collect funds while giving as little attention as legally feasible to the patient in our medical-legal society. I do not wish to sound overly altruistic, but I would like to see a return to the idea that even negative results of a physical examination build the relationship between a doctor and a patient, and this relationship cannot be measured in monetary terms.
Gerson LT. Quality Doctor-Patient Relationships Cannot Be Bought. Arch Intern Med. 1999;159(21):–. doi:
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