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

News Release
Dec. 4, 2008

Alwyn Cassil (202) 264-3484 or acassil@hschange.org

WASHINGTON, DC—Despite 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 HSC’s 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 information—especially 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 study’s findings are detailed in a new HSC Research Brief—Word of Mouth and Physician Referrals Still Drive Health Care Provider Choiceavailable here.

Other key findings include:

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The Center for Studying Health System Change is a nonpartisan policy research organization committed to providing objective and timely research on the nation’s 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 Research, Inc.