It must really be broken for the head of the American Heart Association to speak up. Cardiologists and other procedure-heavy specialties are the beneficiaries of the procedure-tilted reimbursement system:

Incentives in today’s health-care system encourage procedures over doctor-patient face time, according to Gibbons. Many serious illnesses are preventable, but their numbers continue to rise in part because doctors “don’t have enough time for preventive health measures,” he said.

Insurance companies do reimburse at higher rates for procedures. For example, Medicare pays a doctor $55.22 for a 15-minute office visit with an established patient. For a 30-minute visit, the reimbursement is $101.22. But a relatively straightforward procedure like the puncture and aspiration of a cyst pays $117.90. Removal of a foreign body requiring an incision nets $141.06.

“As a result, we spend a lot of money on the expensive things and don’t pay enough attention to the little things,” Gibbons said. “It doesn’t mean that doctors are bad people. It simply means that, like everyone else, they respond to the structure of the system and the incentives of the system.”