I can't begin to adequately express my frustration with the Medicare annual wellness visit (AWV). I tell my patients that their annual physical has three agendas: their agenda, my agenda, and Medicare's. I routinely have them go first and address their concerns. Then I do the AWV tasks, to get them out of the way. Then we get to my usual thorough history and physical. Note that the AWV doesn't really include a physical, nor does it actually foster chronic disease management. It seems Medicare intended that to be a whole separate visit, which would mean two long visits, the second one possibly subject to a deductible. Then there's the issue of glaucoma screening – the eye doctor's area of expertise, but not mine. It takes 30 minutes of nursing time to do all the screenings, provided that they are normal. Any follow-up screening is left to me, in addition to all of the above, which typically takes an hour. I fail to find the “added value.” There is one thing I know for certain: When I turn 65, I will categorically refuse anything resembling the Medicare AWV.
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