The building contractor chatted pleasantly while I checked his blood pressure, waist circumference, recent cholesterol levels, fasting glucose and urine protein. We discussed screening for bowel cancer with “the poo test” versus colonoscopy, with reference to his family history. We talked in detail about prostate cancer testing and I offered to provide him with written information as we were out of time. As I signed his script for the blood pressure medication he winked at me.

“That was easy money for you, wasn’t it?” he said as he walked out.

Thirty-seven dollars and five cents is the value this government places on up to twenty minutes of my time. This figure, the amount a practice receives from Medicare for a standard consultation, has not changed in four years, and under the current arrangement, will not change for another three. I myself receive sixty five percent of that. But are the pennies…