Take down the Christmas lights? Check.

Write up New Year's resolutions? Check.

Get an MRI and have a tooth filled? Check.

The end of the calendar year brings plenty of ritual. But topping the to-do list for many people is the medical mad dash - a scramble to address health care needs before co-pays rise, new deductibles take effect and flexible spending accounts expire.

It was playing out Tuesday at a local Medicine Shoppe Pharmacy, where pharmacist Hope Mullally said she was too busy to give an interview, in part because of the last-minute rush. Dublin Primary Care was also experiencing a year-end surge, as was Rangewood Dental's Dr. Gary Hickenlooper.

"It's almost like the two-minute warning in football," said Dr. Lawrence Zyskowski, a rheumatologist and chairman of the board for Colorado Springs Health Partners, the area's largest physician-owned practice.

Although an end-of-year spike in business is something many doctors and other health care providers typically observe, some speculate that the soaring costs of health insurance in recent years and the financial insecurity of the recession are creating new urgency for some of their patients.

Zyskowski said patients report that co-pays will increase by 100 percent or more on Jan. 1. For others, the new year means meeting an expensive deductible - sometimes thousands of dollars - all over again. People have been rescheduling their early 2009 procedures and tests, such as costly intravenous medication treatments and diagnostic tests like MRIs, to December, he said.

Another doctor, CSHP internist Dr. R.A. McConnaughy, sees mostly elderly patients on Medicare who similarly try to squeeze in colonoscopies, heart tests and other procedures before Jan. 1. One person, he said, was scheduled to come in today to avoid the $600 deductible the procedure would have meant in two weeks.

Lonnie Cramer, director of Imaging Services for Penrose-St. Francis Health Services, said demand for expensive diagnostic procedures goes up in the first two weeks of December.

And, in an economic climate where layoffs are seemingly announced weekly, some people may wonder how much longer they'll be insured.

"If there's any possibility that your job could be changed or eliminated ... you're probably going to take care of anything and everything you can think of sooner rather than later," said Eric Hirschberg, executive vice president at Lockton Cos., an employee benefits consulting firm. He predicts that for some health care providers, business will continue to thrive into 2009 based on such uncertainty about employment.

There are no hard numbers on 11th-hour patients, and not every health care provider reports such stories.

At Dr. David Gibbon's family practice, December seemed no different than any other month, he said. Local Walgreens' pharmacies see more business in January and February than in December, said spokesman Robert Elfinger., although the chain sees some evidence nationally of people getting end-of-the-year refills of routine medication.

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Contact the writer: 636-0198 or brian.newsome@gazette.com