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Dr. Maura Shea looks through an otoscope during an examination of patient Michelo Cineas at the Codman Square Health Center in Dorchester, Mass. - 


Steve Chiotakis: It's the end of the year and the rush is on for the doctor's office. People who've met their yearly health insurance deductibles are making appointments today and tomorrow. Once the new year rolls around, a lot of doctor's office bills come out of pocket. Danielle Karson reports.

Danielle Karson: Patients are cramming into doctors' and dentists' offices -- whether they're sick or not.

Anne-Marie Martinez: I try to get as many doctors' appointments in as possible.

Karson: How many would you say that you do?

Martinez: Probably six in December.

Anne-Marie Martinez waits in the lounge of the Rockville Internal Medicine Group outside Washington while her husband sees his doctor. They met their deductible months ago, and are packing in doctors' visits before the new year.

Doctor Shishir Khetan usually sees about 85 patients a week. This month, the tally is over a hundred.

Doctor Shishir Khetan: I think it's been a little bit more prominent this year. Some people may lose their jobs next year, so maybe they're thinking ahead and saying well, I may as well get my health insurance done now.

All these jammed appointments seem harmless enough: doctors make more money; patients see to their health care needs. But Khetan says the problem is, all those last-minute appointments can crowd out sicker patients.

Khetan: It kind of makes it a little lopsided because we have less access to acute visits, so access to health care is definitely being affected.

In more ways than one, says Henry Aaron, a health care analyst at the Brookings Institution.

Henry Aaron: If you are encouraged financially to go to the doctor at the end of the year, for even very minor reasons, you're going to be spending money that's comparatively high cost relative to the benefits you receive, and that's wasteful.

Aaron says it's no wonder that the U.S. health care system is the most expensive in the world.

In Washington, I'm Danielle Karson for Marketplace.