A mistake was made about 40 years ago in medicine. A mistake that would determine the course that American medicine would take in the years to come. This mistake was solely responsible for the procedure-centered model that our system has become. This probably came to be because the doctors elected to create it were surgeons and not a single primary care physician was on the panel. What these doctors decided was to pay exponentially more for procedures in medicine than for preventative care. I can see how some of this came about. Preventative care was in its relative infancy then, so there would not have been as many people to advocate for it. But that single decision is why physicians choose to go into lucrative specialties over primary care now and why technologic advancements mainly occur in regards to our procedural abilities. They simply pay more. This decision is why your grandparent cannot find a physician in their town, there just aren't enough to go around. The fallout of from this decision is twofold, the first I have already mentioned. The second is that procedures tend to be favored over watchful waiting. Our retired doc here tells a story about how they used to save gallstones from real cholecystectomies to be used in ones that were found to have normal gallbladders during the surgery. The patient still had their gallbladder taken out, they just had a stone shoved inside it before it was shown to them afterwards. Diagnostic procedures also were favored, although the cost-cutters are starting to go after them now as well. As for surgeries, just wait surgeons...they're coming for you, as well; they've already squeezed the PCPs for everything they can.
Retired Doc: "That patient I consulted you to see died a short time ago."
Dr. Echo: "Well, it's a shame she had to die without the benefit of an echocardiogram."