Like many retirees, one couple from upstate New York visit doctors in their winter getaway in Florida. But on a recent routine checkup of a pacemaker, a cardiologist there insisted on scheduling several expensive tests even though the 91-year-old husband had no symptoms.
“You walk in the door, and they just start doing things,” said Sally Spencer, 70, who canceled the tests after her husband’s longtime doctor advised her by phone that none of them were needed.
The couple’s experience reflects a trend that has prompted some doctors up north to warn their older patients before they depart for Florida and other winter getaways to check in before agreeing to undergo exams and procedures. And some patients have learned to be leery after being subjected to tests — and expenses — that long-trusted physicians at home never suggested.
Medical testing is a huge industry in the United States, with prices that are highly variable in different parts of the country. And while Medicare — the government insurance program for those over 65 or with disabilities — strictly regulates the price of tests and procedures, doctors who treat seniors can increase revenues by simply expanding the volume of such services and ordering tests of questionable utility.
In some areas where many retirees live, most notably Florida, the data suggests that they do. In 2012, according to a New York Times analysis of Medicare data released last year, more than twice the number of nuclear stress tests, echocardiograms and vascular ultrasounds were ordered per Medicare beneficiary in doctor’s offices in Florida than in Massachusetts.
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Jeffrey R. Ungvary President