More Patients Visiting Specialists than Primary Care Docs

A study conducted by IMS Health found that 51% of physician office visits in 2013 were with specialists, marking the first time specialist visits have surpassed primary care visits.

The rates of specialist visits have been on the rise for a few years, with a rate of 48% in 2011 and 49% in 2012. IMS is attributing this increase to the aging of the Baby Boomer generation, who require specialized care for a number of illnesses.

A study from the Agency for Healthcare Research and Quality reported that approximately 1 in 3 physicians in 2010 practiced in primary care, not counting hospitalists and primary care physicians who work in emergency departments (EDs), which could also impact the rates of primary care visits.

Another potential contributing factor noted for this change is the decline of health maintenance organizations and the growth of preferred provider organizations, which allow members to self-refer to providers in their network.

The increase in specialist visits is cause for concern in terms of healthcare spending and costs. Uncoordinated care can drive up costs, as specialists potentially duplicate lab tests, diagnostic imaging, and other services. The growing Medicare population with multiple chronic illnesses will only exacerbate this trend.

Healthcare spending in 2014 is already on the rise, according to reports from the US Bureau of Economic Analysis in the US Commerce Department as well as the Altarum Institute.

However, specialists may be helping healthcare spending by keeping patients out of the hospital. The IMS study indicated that hospital admissions in 2013, including those from EDs, rose 2.6%, which was characterized as flat growth. In this regard, specialists appear to be reducing the most expensive form of medical care.—Kerri Fitzgerald

Source: IMS Health. 2014. IMS Health Study: Spending Growth Returns For U.S. Medicines.