People Are Avoiding the Doctor. Why?
by Dr. Mian Majeed
A recent New York Times article entitled Why People Are Still Avoiding the Doctor (It’s Not the Virus) along with other reports, including U.S. Census Bureau Survey results, confirm a trend - people are avoiding the doctor. In fact, the decline in visits has been so dramatic that many primary care practices could go out of business permanently. In this post we explore an often overlooked reason that explains declining office visits and why Click2MD’s direct-to-consumer healthcare model is more relevant than ever.
Skipping The Doctor
According to the Kaiser Family Foundation, 48% of adults say they or someone in their household have postponed or skipped medical care since the Coronavirus outbreak began. While many primarily attribute the decline in visits to the fear of being exposed to the virus, there is likely another major reason - the cost of care.
About Half Of The Public Says They Have Skipped Or Postponed Medical Care Because Of The Coronavirus Outbreak
As Americans face record unemployment and uncertain economic prospects many are, understandably, seeking to reduce expenses and delay spending. At the same time people also face the prospect of losing their employer-sponsored health insurance. Usually there are ‘must pay’ expenses that are prioritized (i.e. groceries, rent, heat, car payment) as the consequences of not paying are significant and immediate (i.e. going hungry, eviction, repossession). For some, healthcare and the associated expenses also fall into a ‘must pay’ expense category, but many will skip care to save money, as the consequences of doing so are not usually immediately felt. In addition, there is also a fear of what medical care may cost and so people are hesitant to go to the doctor if they don’t know what the ultimate bill will be.
Delaying care though ultimately can lead to more complications and expense. Take the example of Thomas Chapman in the New York Times piece. Mr. Chapman, 64, lost his job in March and although he has high blood pressure and diabetes, he decided against refilling any prescriptions. By skipping medications, he runs the risk of complications from chronic diseases, which could lead to a decreased quality of life. In addition, certain complications could result in a trip to the ER and/or hospitalization. The costs associated with an ER visit or hospitalization would far outstrip the money saved from not taking his medications. The risk though is not lost on him, but rather he believes there is no other choice.
“I stopped taking everything when I just couldn’t pay anymore,” he said. After his legs began to swell, and he felt “very, very lethargic,” he contacted his doctor... - Thomas Chapman, 64
Mr. Chapman is not alone, and the article notes other examples of people skipping care due to fears around the costs.
“I’ve put off medical care that doesn’t involve the baby,” she said, noting that her out-of-pocket cost for an M.R.I. to find out what was wrong “is not insubstantial.” - Eli Fels, a swim instructor and personal trainer who is pregnant
Consumer Reports also highlights some interesting data points around the potential implications of delaying care. It cites the CDC, which calculated that in the 10 weeks after COVID-19 was declared a national emergency on Jan. 31, visits to the ER for heart attacks dropped 23 percent, visits for strokes dropped 20 percent, and visits for uncontrolled high blood sugar dropped 10 percent. However, it’s unlikely the incidences of these conditions declined, but rather they went untreated. While only early data points exist, Dr. Luis Isola, director of cancer clinical programs at Mount Sinai in New York, frames the current decline in visits as follows: “If in the next several months we see a wave of patients with advanced oncological conditions, untreated hypertension, coronary disease that should have been treated—that will confirm our worst fears.”
An Existing Issue Made Worse
Ultimately, the economic strain on many households caused by the coronavirus pandemic has not created a new healthcare issue, but rather exacerbated one that existed. For example, according to a February 2018 poll conducted by the University of Chicago and the West Health Institute, 44% said they didn’t go to the doctor when they were sick or injured in the last year because of cost. In fact, the survey found more people fear the medical bills that come with a serious illness than fear the illness itself!
CNBC asks the CEO of the Cleveland Clinic what skipping medical care could mean for patients long term, and the nation’s health overall.
Furthering the University of Chicago/West Health Institute survey insights, research by CarePayment, a leading patient financial engagement company, also found that 61% of Americans have no money saved for their healthcare expenses, and 64% say that they have avoided or delayed medical care in the last year due to expected costs. What’s particularly striking to us about these studies is many of those surveyed had health insurance, but are still having trouble paying medical bills.
According to the Kaiser Family Foundation, half of all covered workers faced deductibles of at least $1,000 in 2016 for single coverage, meaning that they paid at least $1,000 before their health coverage kicked in. And yet, 6 in 10 Americans don’t have $500 in savings, according to a report from Bankrate. - CarePayment
Click2MD
We founded Click2MD to achieve a simple objective: Provide quality care at an affordable and transparent price. To do this, we adopted a practice model known as Direct Primary Care (DPC). DPC practices work outside of insurance and can be best described as cutting out as many third parties as possible, so most of a patient’s healthcare relationship is directly with their physician.
For example, a sick care visit, including a 15 minute follow-up, is $59 at Click2MD. If you want a physician to help you manage your medications the cost is $29 per month at our practice. You know the price coming into your appointment and there will never be any surprise bills weeks or months after. You can find all our pricing and services, including our telemedicine offering and medical home care program, here.
Whether COVID has financially impacted your household or you are looking for a new medical practice, we believe Click2MD can provide a quality and affordable option. Please email us at info@click2md.healthcare or call us at (716) 528 0000 if you are interested to learn more.
__________________
Dr. Mian Majeed has practiced medicine for over 40 years and trained at the University of Massachusetts Memorial Health Center and West Virginia University. He has taken care of patients with various illnesses in emergency departments, medical units, and intensive care units for nearly four decades.