Patterns of Visits to Physicians' Offices, 1980 to 2003

One Pagers | Sep 01, 2005 Marey Dodoo, PhD; Ed Fryer, PhD; Larry Green, MD; Robert Phillips, MD, MSPH; Ginger Ruddy, MD; Jessica McCann, MD

In the past quarter century, the number of office visits to physicians in the United States increased from 581 million per year to 838 million per year, with slightly more than one half of total visits since 1980 being made to primary care physicians. Most visits to primary care physicians were made to family physicians (FPs) and general practitioners (GPs) until the mid 1990s, when visits to general internists and general pediatricians exceeded visits to FPs and GPs.

Millions of people visit physicians' offices in the United States each year. According to data from the National Ambulatory Medical Care Survey, there has been a large increase in such visits since 1980.1,2 From 1980 to 2003, the number of office visits made each year increased by more than 40 percent, from about 581 million to about 838 million (see accompanying tables).2

Table 1. Annual Visits to Physicians' Offices, 1980 to 2003:
Average Number of Visits Per Year (in millions)

PeriodTo all physiciansTo FPs and GPs
Period: 1980 to 1984To all physicians: 581To FPs and GPs: 191
Period: 1985 to 1989To all physicians: 665
To FPs and GPs: 200
Period: 1990 to 1994To all physicians: 707
To FPs and GPs: 189
Period: 1995 to 1999To all physicians: 761To FPs and GPs: 187
Period: 2000 to 2003To all physicians: 838
To FPs and GPs: 201
Period:

FP = family physician; GP = general practitioner.

Source: Information from reference 2.

Table 2. Annual Visits to Physicians' Offices, 1980 to 2003:
Percentage of Total Visits Per Specialty

PeriodFPs and GPsGeneral internistsGeneral pediatriciansPrimary care physicians*Other specialists
Period: 1980 to 1984FPs and GPs: 33
General internists: 12General pediatricians: 11Primary care physicians*: 56Other specialists: 44
Period: 1985 to 1989FPs and GPs: 30
General internists: 11General pediatricians: 12Primary care physicians*: 53Other specialists: 47
Period: 1990 to 1994FPs and GPs: 27
General internists: 14General pediatricians: 11Primary care physicians*: 52Other specialists: 48
Period: 1995 to 1999FPs and GPs: 25
General internists: 16General pediatricians: 11Primary care physicians*: 52Other specialists: 48
Period: 2000 to 2003FPs and GPs: 24
General internists: 16General pediatricians: 12Primary care physicians*: 52Other specialists: 48
Period:

FP = family physician; GP = general practitioner.
*-FPs, GPs, general internists, and general pediatricians.

Source: Information from reference 2.

During the past quarter century, more than one half of all visits made to physicians' offices in the United States were to primary care physicians. Although the overall number of visits to physicians has increased, the proportion of these visits made to primary care physicians, while remaining greater than 50 percent, has declined since 1980. This corresponds with a decline in the proportion of visits made to FPs and GPs during this period. The proportion of visits made to FPs and GPs declined by about 9 percentage points, whereas the proportion of visits made to the offices of general internists and other specialists increased by about 4 percentage points, and there was little change in the proportion of visits made to general pediatricians.

These shifts could influence health outcomes for the population and overall health care costs, and threaten the sustainability of the U.S. health care system.3

References

  1. Green LA, Dodoo MS, Ruddy G, Fryer GE, Phillips RL, McCann JL, et al. The physician workforce of the United States: a family medicine perspective. Washington, D.C.: Robert Graham Center, 2004.
  2. Centers for Disease Control and Prevention, National Center for Health Statistics. National Ambulatory Medical Care Survey. Analysis by the Robert Graham Center, 2004.
  3. Starfield B, Shi L, Grover A, Macinko J. The effects of specialist supply on populations' health: assessing the evidence. Accessed online August 5, 2005, at: http://content.healthaffairs.org/cgi/content/abstract/hlthaff.w5.97v1?ct.

The information and opinions contained in research from the Graham Center do not necessarily reflect the views or the policy of the AAFP. 

Published in American Family Physician, Sep 1, 2005. Am Fam Physician. 2005;72(5):762. This series is coordinated by Sumi Sexton, MD, AFP Associate Medical Editor.