Accounting for the costs of tests

Thank you for your recent article on overtesting.¹ Society will eventually demand accounting from physicians for the costs generated by the tests they order. Saskatchewan physicians periodically get a printout of the costs they generate per patient and their rank scores in relation to their peers. I believe few physicians pay attention to these printouts. Unfortunately, patients often praise family doctors for the number of tests and referrals they do. If we are going to rely more on good history taking and examination skills, we must find a way that provides physicians the required time and be able to demonstrate the value of the time spent. Unfortunately, all the time in the world does not take the place of a prostate-specific antigen test, although a rectal examination might give some clues.