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I addressed this in an earlier comment, but I want to reiterate, doctors did not choose or design this system, and we don't like it. The government designed this system, and the insurance companies followed it. To answer your question, if you go to your doctor for a physical, that means they are looking for nothing to be wrong with you. If you complain about ANYTHING, that is called an ACUTE COMPLAINT, and gets an extra charge. The idea (set up by the government) is that if you had something wrong (i.e. the acute complaint), you should have seen your doctor about it before your physical exam, not to wait until you have a physical. And yes, the Medicare system, and most insurance companies have followed, want you to go for a physical when you have nothing to complain about just to get screenings, and do not want you to wait until you go to the doctor for a physical exam to address a problem. Often they will not pay for something extra at the physical exam and want you to be scheduled for a different time. I will address small concerns (as in this article) without putting in a charge for it, but if there is a major new complaint, I reschedule the physical exam and address the acute complaint. What you are calling the "right way" is actually according to Medicare and your insurance company the wrong way. If you don't like the way it is, PLEASE call your congressional representative and have this broken system fixed, and stop blaming your doctor for something he can't control. Many doctors have stopped, and about 40% of doctors (including me) are considering doing away with accepting insurance altogether because we hate being blamed for and having to deal with exactly what you are complaining about. By the way, it costs me about $50,000 per year to collect money from your insurance company, who tries to find all kinds of ways not to pay me for the work I do.