Family medicine has entered a new frontier thanks to the implementation of Medicare Annual Wellness Visits a few years back. Medicare began recommending these visits on an annual basis as a way of hopefully reducing costs by approaching medicine from a preventative standpoint. The question now being asked by doctors and patients alike is whether such visits are really necessary or not.
We can make the case either way. People who believe in the benefits of preventive medicine can easily demonstrate how annual wellness visits could lead to better health by helping guide patient decisions and actions. Those who think preventative medicine is overhyped can cite plenty of data that questions the validity of wellness visits.
The answer seems to be found in our adoption of outcome-based medicine. In other words, family medicine is now more about satisfying patients by delivering quality care that produces positive outcomes. It is less about rendering a service and charging a fee. So if outcomes are more important, we need to look at how patients feel about wellness visits.
Some Fear and Trepidation
Wellness visits, on the whole, are not a big deal to a lot of people. They are to some Medicare patients, though. Why? Because of our inherent distrust of government programs. More than one Medicare patient has expressed concern to his or her family medicine doctor that wellness visits are just a way for Medicare to save money by sending them to the grave more quickly.
This fear is born out of the fact that wellness visits for Medicare patients often involve end-of-life discussions. They involve eliminating some non-essential care that will not necessarily prolong life or make it more comfortable. Some patients see this as a way to hasten the inevitable, thus costing Medicare less money.
Whether they are correct about government intentions are not does not change the fact that there is some fear and trepidation that comes with Medicare wellness visits. Outside of the Medicare environment, it is an entirely different ballgame.
Wellness Visits for Non-Medicare Patients
When you talk to patients outside of the Medicare system, they view wellness visits in an entirely different light. They tend to see wellness more as a preventative tactic that improves a person’s overall health in the long term. Such patients are more willing to participate in wellness visits because they perceive them as being a tool for creating a happier, healthier life.
Wellness Visits and Doctors
There doesn’t seem to be a whole lot of disagreement about wellness visits among the doctors who conduct them. By and large, doctors favor preventative medicine whether they work as locums, own their own practices, or work as employed hospitalists.
In terms of the visits themselves, locum physicians may have a more challenging time with them because they don’t have long-established relationships with patients. They do not know the histories, they don’t know the family dynamics, etc. But they can still conduct wellness visits from the same third-party, medical perspective employed by private practice owners and hospitalists.
Wellness Visits in Summary
After all this discussion we are no closer to answering the question of whether wellness visits are really necessary or not. That answer may never be found. We may have to resign ourselves to the idea that the necessity and efficacy of wellness visits relies solely on how patients perceive them.
In outcome-based model, patient perception is one of the most important driving factors. If they want access to wellness visits, we give them access. If they are not interested, then we move on. It is as simple as that.