- The Washington Times - Monday, October 1, 2012

Americans visit the doctor less than they did a decade ago, but — as is often the case in the complicated world of health care — it’s unclear whether that’s good or bad.

Nonsenior adults visited a medical provider an average of 4.8 times each year in 2001, but by 2010, that average had fallen to 3.9 annual visits, according to a U.S. Census Bureau report released Monday. And not only did people with health coverage see a doctor less frequently, but so did those who lacked insurance and Americans who reported fair or poor health.

Health-care analysts said the findings were a mixed bag, illustrating an industry that is struggling to stem rising costs but offers better and more efficient services every year.

For one thing, health-care innovation has allowed patients to get more done in a single doctor’s visit, as physicians install more medical equipment right in their offices. And as more medications become available over the counter — such as drugs for common allergies or gastrointestinal ailments — patients don’t have to stop by just to obtain a prescription.

“Where there are good products out there across the counter — before, they were going to get the prescription written,” said Kathleen Stoll, deputy executive director of Families USA.

Americans also may be hesitating more before they rush to the doctor’s office with mild symptoms. Employers have trimmed back on health insurance plans as they grow more expensive, sending more employees into high-deductible plans that require them to pay more out of pocket at the doctor’s office.

As a result, more Americans are thinking twice before they go to the doctor for something like a sore throat or a routine checkup, said Joseph Antos, a health-care analyst at the American Enterprise Institute.

“When you make people more aware of cost, they ask the legitimate question, ‘Gee, do I have to go in for two months in a row for a well-baby visit, my baby is well,’” Mr. Antos said. “I think people are becoming much more aware of the cost in terms of their out-of-pocket cost.”

More than 1 in 5 Americans with private insurance are in high-deductible plans — an all-time high that is growing higher by the year, the Employee Benefit Research Institute found last year.

But even if high-deductible plans help people become less wasteful of health-care services, the flip side is that they may forgo preventive care and rack up more health costs in the long term, Ms. Stoll said.

“People are less dependent on going to the doctor for every sniffle, and that might be a good thing,” she said. “On the other hand, people might be saying ‘I can’t afford my preventive checkup.’”

The problem of affordability is especially acute among the uninsured; less than one-fourth visited a medical provider in 2010, the survey found — even lower than the 28.4 percent who received professional medical attention in 2001.

Ms. Stoll pointed to medical providers, who have become more vigilant about trying to collect payments as they grapple with rising health-care costs.

“We do see more aggressive collection practices, so the uninsured might think, ‘Wow, I’m not going to be able to negotiate with the doctor, I’m going to be hit with the bill,’” she said.