What Do Patients Think About U.S. Health Care System?

2017 Survey Provides Some Answers

October 17, 2017 01:53 pm Sheri Porter

Recently released results from The Physicians Foundation 2017 Patient Survey(www.physiciansFoundation.org) provide insight into what consumers across the United States think about the nation's health care system and the physicians who care for them.  

Samuel Church M.D., M.P.H., left, a family physician in Hiawassee, Ga., makes the most of face time with patients like Margaret Hedden, shown here in 2015 with (then) medical student James Eames.

The survey touched on four key areas: the physician-patient relationship, the cost of health care, social determinants of health and lifestyle issues.

The 2017 patient survey -- the second of its kind commissioned by the foundation in the past two years -- garnered data from 1,747 respondents between the ages of 27 and 75. Each participant had seen his or her doctor at least twice in the preceding 12 months.

The survey was conducted online June 19-30, and authors of the 2017 patient survey report compared it to data collected from the foundation's 2016 patient survey, as well as to responses from the foundation's 2016 Survey of America's Physicians.

Report co-author Gary Price, M.D., a clinical assistant professor of surgery at Yale-New Haven Hospital in New Haven, Conn., is a board member of The Physicians Foundation and chairs its Strategic Planning Committee and Physician and Patient Perception Task Force. He told AAFP News that the foundation's mission is to improve the quality of health care for everyone in the system and noted that the foundation has conducted four biennial surveys of physicians, the latest published in 2016.

Story Highlights
  • The Physicians Foundation recently released results of its 2017 patient survey.
  • Survey results show patients are pleased with their primary physicians but wish they had more face time during office visits.
  • Patients also gave electronic health records a thumbs up, said their physicians should listen more, and wanted physicians to be patient advocates in the health care system.  

"We decided that since physicians' main goal is to take care of patients, it was important to see how patients perceive some of those issues that we polled physicians on," said Price.

Survey Highlights

The survey results held some good news for physicians. Overall, patients said they were happy with the care they receive from their primary physicians. In fact, a whopping 95 percent of patients were somewhat or very satisfied with their overall relationship with their physician, and 80 percent said they had thought very little or not at all about changing physicians.

But clearly patients and their physicians want more face time during office visits, with only 11 percent of patients and 14 percent of physicians responding that they have all the time needed to provide the highest standards of care.

Other questions on a variety of topics elicited these responses from patients:

  • 85 percent said electronic health records helped somewhat or a great deal in patient care.
  • 77 percent wished their doctors would listen more.
  • 96 percent said physicians should strongly or somewhat advocate for their patients, but just 79 percent think physicians currently do so.
  • 89 percent were concerned about health care costs affecting them in the future.
  • 56 percent said the cost of prescription drugs and other pharmaceuticals were the chief factor in the high cost of health care; second on that list was the absence of free markets, at 24 percent.
  • 87 percent said poverty had a least some impact on the cost of health care.

Patients also had strong opinions on how to ensure the success of the U.S. health care system in the future. For instance, 91 percent agreed that all health care stakeholders must work together to address challenges that make the current system hard to understand.

And 90 percent of respondents agreed that

  • physicians and patients create a partnership that is the most essential element in a quality health care system, and
  • as leaders in patient care physicians must be the loudest voice in discussions about health care access, cost and quality.

Author Discussion: Physicians as Advocates

The survey covered a lot of territory, but from Price's perspective, one of the most significant takeaways is recognizing a growing patient sentiment that the overall leadership role of physicians is in danger.

"It has taken a back seat to a number of forces in the health care debate, and patients quite accurately perceive that there are forces greater than the physician who just examined them -- and that those are dictating patient care," said Price.

He said he was not at all surprised that patients think insurance companies, pharmaceutical and medical device companies, and Congress have more impact on decisions about patients' treatment than physicians.

Price said he was surprised, however, that the gap had widened since just last year.

In 2016, 83 percent of patients said health insurance companies had the most leverage regarding treatment options; in 2017 that response grew to 92 percent. Furthermore, when comparing 2016 and 2017 surveys, patients detected a growing influence from other entities, as well. For instance, the perceived influence of

  • pharmaceutical and medical device companies rose from 68 percent to 84 percent,
  • Congress rose from 60 percent to 77 percent, and
  • state government rose from 54 percent to 72 percent.

"In the meantime, physicians slipped and lost 5 percentage points," dropping from 79 percent to 74 percent, noted Price.

"Patients see their physician as their last best hope when confronting this bureaucracy of insurance companies and government regulations that interfere with the delivery of care on a daily basis," Price said -- think preapprovals and treatment protocols. And yet physicians recognize that they are losing ground in this area, he added.

When asked about physicians' ability to significantly influence the health care system, 70 percent of patients responded positively compared to just 41 percent of physicians.

"We have a real problem in this disconnect between our patients' quite appropriate expectations of us as advocates both in the political debate and in the exam room and the physicians' perception of what they're able to do," said Price.

He pointed to the foundation's role in developing physicians' leadership skills, with the end goal of amplifying the physician voice in the overall health care debate.

"Our patients realize that the physician perspective will be critical in shaping a system that actually works for the patients and those providing the care. I think physicians want to play that role.

"We've got to make sure that everyone involved in those discussions is willing to hear physicians' input and that physicians feel empowered to take part in that," said Price.