Marvin S. Wool, MD
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Wool MS. Public Expectation for Annual Physical Examinations. Ann Intern Med. 2002;137:773. doi: 10.7326/0003-4819-137-9-200211050-00020
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Published: Ann Intern Med. 2002;137(9):773.
TO THE EDITOR:
Oboler and colleagues (1) report that patients, shielded from the actual costs, tend to demand periodic physical examinations and testing deemed inappropriate by health professionals. More important, however, they find that many patients would forgo those services if faced with the actual out-of-pocket costs. Unmentioned is the failure of physicians, individually and organizationally, to discourage demand for inappropriate preventive services. This is particularly ironic since elsewhere in the same issue of Annals, Stone and coworkers (2) comprehensively detail strategies to encourage use of appropriate periodic preventive testing. Individually, physicians paid by current health insurance plans, whether fee-for-service, managed care, or government, are at best unmotivated to discourage use of inappropriate services and at worst financially rewarded for encouraging their use. Organizationally, the American College of Physicians–American Society of Internal Medicine, among others, has for more than two decades formulated, published, and disseminated to its membership evolving preventive care guidelines. However, as Oboler and colleagues' work shows, any efforts to share those guidelines with the public have had little demonstrable effect on patient behavior.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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