The other day, I saw a senior citizen for an annual wellness visit. He is a well controlled diabetic. One of the quality parameters that gets me brownie points and brings extra money to my practice is that we document an eye exam, a kidney function blood test and a urine test to look for the early warning signs of diabetic kidney disease. We are also judged on whether he takes a statin drug to lower his heart attack risk, regardless of what his cholesterol numbers are and that his blood pressure is within range.
We only got his urine test done a couple months ago, near the end of 2025. When I did his wellness visit the other day he had received a urine cup from his insurance company. I told him that it would be kind of silly to do that test now because he had it just a couple months ago. He should really have it toward the end of the year. If he doesn’t do it by then I will get dinged, but if he does it now it’s going to be fine and it wouldn’t serve any medical purpose. This is a common dilemma in today’s medicine. Do we do things that make medical sense or do we do things to chase? What in the industry is called “star ratings“?
So here’s a question for my colleagues: Would you have done the urine test now just to get the points or would you do it a year from when you did your last one?
Wait until it makes medical sense. You should get the same points for explaining your reasoning in a sensible straight forward way and honoring the patient/MD relationship and saving an unnecessary lab expense...the plastic cup will keep in good shape until the end of year. There you go, another winning money saving point. They are so lucky to have you.