I'm sure you have figured this out by now, but our rather loathsome system seems to find doing "things" much more valuable that using intelligence. That said, are you careful that you are billing properly for all the little "things" you do? Are you religiously charging for freezing off that skin tag that took 15 seconds at the end of a half-hour visit? Some things are so mindless that I find it distasteful to charge for them until I remind myself that it is how I make my living...
Spirometry can be a useful tool, but I don't use it much (except for our respirator physicals that require it), although that would be different if there were a number of asthmatics in my practice. The question is whether you will be pressured to use it just to make money, or because the information is medically useful. Similarly, simple audiometry has its place if you have reasonable concern that a patient may be exposed to noise but not covered under a hearing protection program. These things are reasonable. However, I have also watched a video "educating" practices on billing that strongly recommended doing thoracic impedance plesthymography routinely based on a manufacturer's recommendation that it supposedly gave information on cardiac output and billed out nicely. The presenter gave this information without the slightest hint of embarrassment.
I find it a constant struggle within myself to decide if I am doing a procedure because I really need the information or because it makes me money. The decision is all too easily warped by avarice. I truly hate this aspect of medical practice.
