NCPA - National Center for Policy Analysis

Some People Won't Go To The Doctor

October 31, 2000

Some people won't seek medical care until they arrive at emergency admitting in an ambulance -- or bypass treatment altogether for the morgue. Nobody knows how many people put off medical visits or whether it is harmful for most people. And there are no national statistics tracking delays in care.

The bottom line for many people is fear: fear of bad news, fear of an uncomfortable test, fear of discussing something intimate.

  • About one in three men and one in five women have no regular doctor, a Commonwealth Fund survey of 4,350 Americans projected, because of cost -- or denial and embarrassment, particularly for men.
  • A study by Richard Frankel and colleagues that found most doctors interrupted patients 18 seconds into an interview, although studies have shown that if patients are unable to express their concerns to a doctor they are not likely to follow the doctor's advice or return for further checkups, said Samuel Putnam, a Boston internist and co-author of "The Medical Interview."
  • Focus groups by the What to Expect Foundation, an organization providing prenatal and early childhood support to low-income women, found that the greatest barrier keeping the women from seeking free prenatal care was their substance abuse or smoking.
  • Lisa Cooper, an assistant professor at Johns Hopkins University medical school surveyed 963 people with serious conditions and found that alcoholics were three times as likely as others to avoid regular care, and those with phobic disorders were about half as likely to return for treatment.

On the other hand, a study of 10,000 patients at the Kaiser Permanente Medical Care Program in Oakland, Calif., found that those who chose their physician were more satisfied with their care and made more outpatient appointments.

Source: Randi Hutter Epstein, "Major Medical Mystery: Why People Avoid Doctors," New York Times, October 31, 2000.


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