DR. GOTT: ‘Churning’ of patients on the rise

Dear Dr. Gott: Is it just my imagination, or are doctors creating extra business for themselves by having patients come in when there is no reason to believe anything is wrong?

I’m 75 and on Medicare and am worn out with going to unnecessary doctor visits or for tests. Not only that, but it’s costing Medicare a fortune.

A few years ago, I had a colonoscopy because there was a complaint that could have warranted it. The doctor found nothing wrong, yet the following year I got a notice that it was time for me to have another one. I didn’t go.

Other doctors seem to think they need to see me every so often whether anything is wrong or not.

What do you think?

Dear Reader: I agree with you. The current nightmare of fee schedules makes doctors crazy; therefore, many have chosen to churn patients. In some cases, relatively healthy people cannot get out of the doctor’s office until they have been given a follow-up appointment.

For example, you had a normal colonoscopy during which nothing alarming was discovered. You do not need another colon exam for 10 years. Having such testing annually is a method of churning.

I remember starting my practice 40 years ago, when people sought medical attention for specific complaints – or, if over 65 years of age, an annual examination. The medical culture has changed, and not necessarily for the better.

My position will tweak some of my colleagues, who will call me a traitor and express their disbelief that I could make such a false value judgment.

That’s OK, but I think those of us who disparage patient churning have a right to be heard.

Dear Dr. Gott: I am writing to you concerning a recurring pain I get in the right side of my abdomen. I have been to my doctor, who referred me to a gynecologist. The doctor told me it was nothing to do with female organs. I am a 57-year-old female and have gone through menopause.

I was wondering if you had any idea what it could be. It really does not bother me until I do a lot of bending over.

Dear Reader: From your brief comments, I have concluded that your abdominal pain may be caused by overuse of your abdominal muscles. Even more likely is gallbladder disease or gallstones.

Your doctor should order a gallbladder ultrasound, a CT scan of your abdomen and pelvis, and other tests of your colon. If, after the testing, your diagnosis is in doubt, I’d recommend a consultation with a gastroenterologist.

Let me know how this turns out.