The trouble is that the McDonalds type business has taken over medicine: Where any doc can see any patient for ten minutes and do as good a job as Dr. X puttering around and discussing the family while he checks your sore throat.

(The “sore throat” will be cultured by the lab, or if you are lucky checked by the Nurse practitioner on call, not you, and so the “unnecessary conversation” where you find grandmom is having incontinence problems (needs to bring in a Urine: probably a UTI) and daughter has a bad boyfriend (bring her in for the pill and an STD/Pregnancy check) or hubby is drinking again(here is the address of Alanon, and do you need the address of the woman’s shelter?) will be ignored, never mind that you often pick up problems that can be headed off by such casual conversation).

But if you make a housecall nowadays, and you you don’t order a test you can be sued for missing something.

And in your office,if you miss a rare cancer or disease, if the lawyer finds that you could have done a test for a couple thousand dollars if you send the person 500 miles to a university for a test that isn’t standard of care, you can be sued.

So don’t blame the docs. Blame the lawyers and the bean counters.