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Despite Higher Costs, 2 in 5 Americans Visit Specialists for Primary Care

By Richard Scott
August 27, 2012

When it comes time to visit the doctor, more than two in five adults in the U.S. see a specialist for general healthcare, despite evidence that strong primary care relationships can boost healthcare quality, improve outcomes and reduce costs, according to new research.
 
Researchers from Mount Sinai School of Medicine in New York analyzed the trends of more than 12,000 patient visits, comparing data over a 10-year stretch between 1997 and 2007. They found that 59 percent of patients seeking “general” healthcare services like check-ups visited a primary care physician. The other 41 percent visited specialists for general healthcare needs.
 
The visiting trends held predominantly the same between 1999 and 2007. Yet the lead authors of the study, which appeared in the Archives of Internal Medicine, believe that patients may be doing themselves – and the healthcare system overall – a disservice by forgoing primary care.
 
Leading the Way to High-Quality Care
 
Despite evidence that primary care-led healthcare delivery can boost the quality of care and cut overall costs, a large portion of Americans visit specialists for their routine needs. While 59 percent visited family physicians, nine percent saw an internist, five percent visited obstetricians-gynecologists, and 27 percent visited other specialists.
 
“It’s very well documented that a system that is based on primary care can provide higher quality care,” said lead author Dr. Minal Kale with Mount Sinai in a statement.

As one example, researchers point to a 2011 study which found a correlation between the number of primary care physicians in a given area and the drop in avoidable hospitalizations among seniors, as well as a decrease in death rate. Recently, there has been a glut of research studies displaying the benefit of primary physician-led healthcare, as encapsulated in the medical home model of care - including decreased health disparities, less unnecessary emergency department usage, better chronic disease management, and even reduced mortality.

Yet the trend of visiting specialists for routine healthcare needs is consistent, and it appears to be ingrained in our healthcare culture. Researchers speculate that patients believe specialists are better than primary care physicians at treating specific conditions. Another reason may be the well-documented shortage of primary care physicians, which may be driving individuals to other professionals.

While Kale believes specialists play an important role across the healthcare continuum, she acknowledges the unique role of primary care, saying that the healthcare system, and professionals, "need to provide patients with a place and [a] physician coordinating care between several specialists, [and] someone they can turn to for critical care," according to the report.
 

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