That's the business model with IU Health. The primaries are the feeders for the high dollar tests and diagnostic procedures and specialists.
This week my 12 year old looking doctor went over all my stuff and said it all looked good. Then she asked me if there were any cancer screenings I thought might be appropriate. I asked her what the hell else was there? I'd had a lung scan, was dealing with my prostate (I have prostate cancer but it's essentially benign -- Google "Gleason score 6"), and had just had a colonoscopy. She shrugged and said okay, then listened to my heart and lungs and gave me a cursory exam on my head and ears... I was just waiting for her to get all concerned about a dark spot on my head and claiming I needed to see a dermatologist, but she just said to wear a hat as much as I could.