Response

This subject is generating much discussion, which helps to drive change. Dr Dickinson’s point is well taken: the Canadian Task Force changed its name and in so doing dropped the term periodic health examination. It is reminiscent of annual checkups and head-to-toe examinations, which are irrelevant. Whatever its name, the sole purpose of this visit is not to develop relationships with healthy patients. For example, many obese patients need more time to discuss lifestyle changes that could change their outcomes in the following decades. Prevention is not always easy to deliver in a short visit. Family physicians are not compensated well for the extra time they spend on these issues while building relationships with all patients. So providing a billing structure that is modernized to cover preventive services in a longer visit can achieve much and serve all patients. Physicians can offer a longer appointment to any patient who needs it, not just to well-to-do patients. In the end, we should be providing relevant, useful care with up-to-date methods. Research can help us to further explore how best to do this.

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