Almost 80% of US consumers have a physician they consider to be their personal doctor and many of them are very satisfied with the care they receive or they would look elsewhere for a new doctor. However, the latest DSS Health Care Engagement Index (HCEI™) survey shows there is still room for improvement.
Uninsured and new HIX members need doctors. It is not surprising that with more limited access to medical care, only 37% of uninsured consumers have a personal doctor. Something harder to explain is why only 76% of consumers with an individual health insurance plan have a personal doctor despite paying for coverage out of their own pocket and having free access to checkups. New health plan enrollees in general and public exchange enrollees specifically are less likely to have a personal doctor.
Half are extremely satisfied, but half are not. On a scale of 0 to 10 where 10 means the best possible personal doctor, 45% of consumers rate their doctor a 9 (20%) or 10 (25%). Consumers heavily Engaged in their health care, those 65 to 79 years of age and those with Medicare coverage are significantly more likely to have a personal doctor and to rate their doctor a 9 or 10. That still leaves 50% of consumers less than delighted with their current physician.
Not enough consumers saying their doctor is the best ever. When given a choice of describing their doctor as the “best ever“, “good enough for the moment“, “the only doctor I have ever had” or choosing from a list of complaints, only 34% said their doctor is the “best ever.” Another 11% said they have “never had another doctor” to compare against, so they are uncertain how good their doctor really is. One-quarter of all consumers say their doctor is “good enough for the moment“, which implies they will look elsewhere at some point in the future. Half of those who said their doctor is “good enough for the moment” also selected one or more complaints such as taking too long to get an appointment, long waits at the doctor’s office, a dismissive attitude when asking questions, language issues, etc. One-third of consumers who said their current doctor is the “only one they have ever had” also mentioned one or more complaints, indicating that they already recognize opportunities for improvement despite their limited experience.
60% of doctor relationships could be upgraded. In a separate question, 27% of consumers said they “would drive across town and pay more” to continue seeing their current physician – a clear sign of loyalty for their physician. However, 30% said they stay with their doctor out of convenience more than anything else, 14% said they would change doctors if they could easily find a better one and 17% stay with their doctor out of fear that they might end up with an even worse doctor. That means about one-third of consumers are ready to change doctors if the process is easy and there is enough information to insure a good decision. Another 30% of consumers might switch if circumstances change.
Utilization is skewed. The typical US adult visited a physician 2.3 times during the past year, but utilization varies across many respondent groups. Almost every Engaged consumer said they visited a doctor at least once in the past year while only 64% of Disengaged consumers did so. When Disengaged consumers visited a doctor, the often did so multiple times, averaging 3.2 visits per year compared to only 2.4 visits for the typical Engaged consumer. Despite a lack of insurance, 50% of uninsured consumers visited a doctor at least once while 89% of those with an individual plan and 97% of those with Medicare had a doctor visit in the past year. Those with 1 chronic condition are not much different from consumers with no chronic conditions, but both groups have significantly fewer visits than those with 2+ chronic conditions (3.4 visits per year versus 1.5 visits per year for those with no conditions). Grouping consumers by BMI produces results similar to those based on number of chronic conditions with overweight individuals having slightly more utilization than those with a normal range BMI, but significant less visits than consumers classified as obese (1.8 visits per year for normal BMI verses 2.7 visits per year for obese BMI).