I’ve see some specific changes on how I am managed that I’m quite sure are driven by insurance. For instance, I have gotten quarterly blood tests to check liver enzymes, sed rate, etc. now I get them twice a year unless he needs to confirm a flare or infection, etc. and now I have follow ups every four months instead of three. I noticed with my pulmonologist the time slot that a follow up visit is given is 15 minutes - and that means we make virtually no contact so he can type his write up while he talks. . I get a hasty stethoscope check of lungs and heart. As a matter of fact, I can’t recall the last time my PCP touched me at all. Anywhere. No checking ankles for swelling, throat for thyroid, poking around for swollen nodes, etc. I get labs annually and then he writes whatever script he can justify to prove he saw me. I think the couple of PAs I see are vastly more focused on me than the docs - rheumy excepted. Rheumy is engaged but I can tells is pressured by insurance company - or at least Medicare.