Physician office visits edge up as preventive care makes gains

While not back to pre-recession levels, the number of patient visits appears to be reversing a years-long decline.

By — Posted Oct. 15, 2012

Print  |   Email  |   Respond  |   Reprints  |   Like Facebook  |   Share Twitter  |   Tweet Linkedin

A U.S. Census Bureau report issued in October showed a marked, decade-long fall through 2010 in medical services utilization by working-age Americans. But the report may represent the bottom of a fall in physician office visits, before the health system reform movement gave patients, payers and doctors incentives to get people into an exam room more often for preventive care.

The Census numbers showed a decline in annual “medical provider visits” from 4.8 in 2001 to 3.9 in 2010 for people ages 18-64. The findings were consistent with what other analysts found during the same period. Although the Census did not dictate a cause for the decline, other analysts said rising unemployment and uninsured status were major factors in patients putting off care and avoiding the expense of a doctor visit unless absolutely necessary.

However, more recent studies are finding that the number of patients going to the doctor started increasing again in 2012. The latest numbers come from Truven Health Analytics, formerly the health care business of Thomson Reuters, which said that in the third quarter of 2012, primary care traffic, including obstetrician-gynecologists, from insured patients increased to 12.7 patients per day from 12.4 per day in the same quarter of 2011. Specialists’ traffic also went up slightly. After a nearly constant decline in quarter-over-quarter visits since 2008, 2012 has featured gains in every quarter, Truven said.

Ray Fabius, MD, chief medical officer at Truven, said his organization’s numbers are an early indication that health reform is succeeding in getting patients back into the doctor’s office. He pointed to accountable care organizations, patient-centered medical homes and other government and private efforts to improve care and reduce health costs, as well as the Affordable Care Act’s requirement that certain common preventive care be covered 100% by insurers, with no co-pay or patient portion.

Those efforts have “removed the financial barriers that keep patients from receiving preventive services that have been proven to have value,” Dr. Fabius said. Those incentives aren’t merely government-driven, he said. “We’re also seeing some employers encouraging people to have relationships with doctors, especially primary care doctors, as they realize that their employees having a relationship with a doctor helps costs go down.”

Expecting future growth

Other reports from investment analysts and industry watchers have noted small gains in visit traffic overall in 2012, reversing previous years’ trends. Unexpectedly high health spending was a big reason why six of the seven largest publicly traded health plans (UnitedHealth Group excepted) recorded earnings declines, not including one-time gains, in the second quarter of 2012, the latest financial information available.

“This is a dynamic situation,” Dr. Fabius said. “There has been remarkable thinking in terms of health reform since 2010,” the latest year covered in the Census report. “We may see some of the early result of this thinking in the [patient visit] numbers.”

Dr. Fabius said he expects patient visit rate increases to accelerate as more people learn that preventive care is fully covered, and even before more patients get insured when the ACA’s requirement that people buy coverage, or pay a penalty, comes into play in 2014.

The growth, Dr. Fabius said, may be limited by how many patients each physician can see in a day and the extent of an expected, mounting physician shortage.

Back to top


Patient visits inching up

View in PDF

Click to see data in PDF.

A decline in office visits by insured patients has begun reversing itself in 2012, thanks in part to reform efforts that have given physicians and patients incentives to give and seek preventive care, according to an analysis of information from 10,000 physicians by Truven Health Analytics. Truven’s data are consistent with other findings that patients, of all ages and insurance status, are coming back to doctors in greater numbers in 2012. Truven’s data are compared by quarter because of seasonal patterns in patient visits. Numbers represent the patient visits per day per physician. Ob-gyn is included in primary care.

1Q Primary care Specialists Total
2008 16.5 7.3 10.9
2009 16.2 7.3 10.8
2010 15.3 7.8 10.7
2011 15.2 7.9 10.9
2012 15.6 8.7 11.5
2Q Primary care Specialists Total
2008 14.6 7.3 10.2
2009 14.6 7.2 10.1
2010 13.8 7.6 10.0
2011 13.6 8.0 10.3
2012 13.9 8.4 10.6
3Q Primary care Specialists Total
2008 13.6 7.1 9.7
2009 13.6 7.2 9.7
2010 13.4 7.8 9.9
2011 12.4 7.8 9.7
2012 12.7 7.8 9.8
4Q Primary care Specialists Total
2008 14.6 7.1 10.0
2009 14.6 7.1 10.0
2010 14.2 7.8 10.4
2011 13.8 8.0 10.4

Source: Truven Health Analytics

Back to top

External links

Average annual expenditures and characteristics of all consumer units, Consumer Expenditure Survey, 2006-11 (including health spending), October (link)

“Health Status, Health Insurance, and Medical Services Utilization: 2010,” U.S. Census Bureau, October (link)

Back to top



Read story

Confronting bias against obese patients

Medical educators are starting to raise awareness about how weight-related stigma can impair patient-physician communication and the treatment of obesity. Read story

Read story


American Medical News is ceasing publication after 55 years of serving physicians by keeping them informed of their rapidly changing profession. Read story

Read story

Policing medical practice employees after work

Doctors can try to regulate staff actions outside the office, but they must watch what they try to stamp out and how they do it. Read story

Read story

Diabetes prevention: Set on a course for lifestyle change

The YMCA's evidence-based program is helping prediabetic patients eat right, get active and lose weight. Read story

Read story

Medicaid's muddled preventive care picture

The health system reform law promises no-cost coverage of a lengthy list of screenings and other prevention services, but some beneficiaries still might miss out. Read story

Read story

How to get tax breaks for your medical practice

Federal, state and local governments offer doctors incentives because practices are recognized as economic engines. But physicians must know how and where to find them. Read story

Read story

Advance pay ACOs: A down payment on Medicare's future

Accountable care organizations that pay doctors up-front bring practice improvements, but it's unclear yet if program actuaries will see a return on investment. Read story

Read story

Physician liability: Your team, your legal risk

When health care team members drop the ball, it's often doctors who end up in court. How can physicians improve such care and avoid risks? Read story

  • Stay informed
  • Twitter
  • Facebook
  • RSS
  • LinkedIn