Word of Mouth and Physician Referrals Still Drive Health Care Provider Choice
Vision of People Picking Providers Based on Price and Quality Information Far from Reality
Dec. 4, 2008
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WASHINGTON, DCDespite myriad initiatives to encourage
people to use health care price and quality information, most Americans still
rely on word-of-mouth and physician recommendations to choose health providers,
according to a national study released today by the Center for Studying Health
System Change (HSC) and funded by the California HealthCare Foundation.
While sponsors of health care price and quality transparency initiatives often
identify all consumers as their target audiences, the true audiences for these
programs are much more limited, the study found.
In 2007, only 11 percent of American adults looked for a new primary care
physician, 28 percent needed a new specialist physician and 16 percent underwent
a medical procedure at a new facility, according to findings from HSCs 2007
Health Tracking Household Survey, a nationally representative survey containing
information on 13,500 adults. The survey had a 43 percent response rate.
"Most Americans still rely on information from friends and family when
choosing a primary care physician, and few Americans actively shop or consider
price or quality informationespecially when choosing specialists or facilities
for medical procedures," said Ha T. Tu, M.P.A., an HSC senior researcher
and coauthor of the study with Johanna R. Lauer, an HSC health research assistant.
HSC is a nonpartisan health policy research organization funded in part by the
Robert Wood Johnson Foundation.
When selecting new primary care physicians, half of all consumers relied on
word-of-mouth recommendations from friends and relatives, but many also used
doctor recommendations (38%) and health plan information (35%), the study found.
Nearly two in five used multiple information sources when choosing a primary
care physician, but when choosing specialists and facilities for medical procedures,
most consumers relied exclusively on physician referrals, according to the study.
The studys findings are detailed in a new HSC Research BriefWord
of Mouth and Physician Referrals Still Drive Health Care Provider Choiceavailable
Other key findings include:
- Use of online provider information was low, ranging from 3 percent for
consumers undergoing procedures to 7 percent for consumers choosing new specialists
to 11 percent for consumers choosing new primary care physicians.
- Approximately 25 million adultsmore than one in 10 adultsreported
looking for a new primary care physician at some point in the previous 12 months.
Seventeen million of these adults found a new PCP, while the remaining 8 million
did not. Among the 17 million who found a new primary care physician in the
past year, half relied on recommendations from friends and relatives, and more
than one in four used such recommendations as their only information source.
- Almost 63 million adultsnearly three in 10said they needed a new specialist
in the previous year, with 46 million actually seeing a new specialist. Almost
seven in 10 of the 46 million relied on referrals from their primary care physician
to find a specialist, with almost six in 10 relying exclusively on this source.
One in five used recommendations from friends and relatives, and only 15 percent
used multiple sources of information. People with chronic conditions and those
in fair or poor health were more likely to rely solely on their primary care
physicians referrals, while younger and more-educated consumers were more likely
to turn to other sources, including the Internet and health plan information.
- About 35 million adultsnearly one in sixreported undergoing a medical
procedure at a new facility in the past year. In choosing facilities for procedures,
consumers were even more reliant on physician guidance. Nearly three in four
consumers who had procedures relied on the referral of the physician performing
the procedure; almost all of these consumers used no other source of information.
Alternative information sources were used by relatively few consumers, and only
one in 12 used multiple information sources when choosing a facility. Older
people and those with chronic conditions were more likely to rely solely on
their physicians referrals in choosing a facility for a procedure.
The Center for Studying Health System Change is a nonpartisan policy research
organization committed to providing objective and timely research on the nations
changing health system to help inform policy makers and contribute to better
health care policy. HSC, based in Washington, D.C., is funded principally by
the Robert Wood Johnson Foundation and is affiliated with Mathematica Policy