Visiting the doctor is often an exercise in inconvenience.
I once read that when you include travel time, waiting time, filling out paperwork, waiting in the exam room, and talking with the office nurse, that 15 minutes of face time with your doctor takes up about three hours out of your day. That sounds a little high, but the average time varies by physician’s specialty and whether the clinic is urban, suburban, or rural.
Then there is the lead time required to schedule a visit. The average time to see a family physician is three weeks (20.6 days), according to a recent survey by AMN Healthcare. That is an improvement from 2017 when the waiting time was 29.3 days. Waiting times for cardiology appointments moved in the opposite direction: three weeks in 2017 and 26.6 in 2022.
Specialist Proliferation
The New York Times wrote on November 24, 2024, about the time taken up by physician visits, especially by seniors, who generally are covered by Medicare and may be retired.
The Times quoted a senior who explained every body part has its own doctor—one for primary care, another for the heart, a lung surgeon, a pulmonologist (for a family history of lung cancer), an ophthalmologist, a gynecologist, a urologist, a podiatrist, a gastroenterologist, and a dentist.
The senior, a woman, estimated she sees a doctor or gets medical services about 24 times a year. She is not alone in that. Medicare data shows people 65 and older average about 17 contacts with the health care system annually (excluding the dentist).
For seniors with a myriad of chronic conditions (14 percent of seniors), contact days with the health care system rise to 30. Eleven percent of seniors see a doctor or some other ambulatory medical service 50 times a year.
Some seniors experience treatment cascades: the more they go, the more a doctor finds wrong, leading to more treatments that can cause more harm than good.
Low-Value Care
The Times article says one way to reduce these time burdens is to eliminate “low-value care.” This category includes services of “dubious worth” such as screening for prostate cancer in men older than age 70, and “unneeded testing before surgery.” The Times suggests health care centers reduce treatment burdens by moving specialists to one building and removing incentives for scheduling multiple tests and visits.
That sounds like happy talk by public health advocates and makes little sense to an economist. Our health care system is not competing on price, quality, or other amenities. Doctors’ schedules are typically fully booked. The only incentive they have to reduce low-value care is if they can instead fill their time with more lucrative patient treatments.
Considering some of the care they provide is performed by others (blood tests, CT scans, physical therapy, etc.), turning away a low-value-care patient is unlikely to boost their income but would reduce their hospital employer’s income.
Socialization Factor
There may be another, more sinister mechanism at work. Many seniors like going to the doctor. A while back I read an article about seniors in Florida, a state with a large senior population. The article claimed visits to the doctor function as social occasions for many seniors.
Seniors go to the doctor and talk to other seniors in the waiting room, compare notes, and recommend new doctors to each other. Strangers they did not know prior to their visit now want to see the doctor another senior raved about. Indeed, it is well-known that seniors living in retirement destinations see their doctors more than seniors living in places with a lower concentration of people in their age group.
I have even talked to some pharmacists and policy analysts who said seniors often refuse to switch to mail-order prescriptions because their trek to the pharmacy is part of a monthly ritual that gives their life purpose.
Interactive Group Therapy
If seniors want a heath care village (you know, it takes a village) with interaction with other seniors and tons of care at low cost, my idea of social-media-based interactive group therapy would work well. Recent data found about half of Generation Z turns to health influencers on TikTok because it’s both convenient and cheap—free actually.
Seniors may not gravitate to TikTok, but most know how to search the internet for information. Surveys going back 20 years have consistently found that more than 100 million Americans search online for health information each year. Google reports there are roughly 70,000 health-related searches every minute. One article even claimed doctors use Google and YouTube to learn about diseases and conditions they treat.
YouTube would be a great way to provide interactive group therapy. Any of the thousands of physicians on YouTube could create interactive group practices and monetize them with a small fee, maybe $20, spread over 100 people. At various times, patients could log on to participate in video chats or live events on different health topics.
Apart from that, it may not be easy to make physician visits less of a pain or to discourage unnecessary trips to the doctor.
Devon Herrick (devonherrick@sbcglobal.net) is a health care economist and policy advisor to The Heartland Institute. A version of this article appeared on the Goodman Institute Health Blog. Reprinted with permission.
