Nearly 1 in 5 Americans haven’t seen a doctor in over five years

Published: April 14, 2021
Reviewed by: Mitchell Fong

While the past year has shed light on inadequacies and inequities in the American healthcare system, many of these issues are unfortunately not new.

According to a new survey by OnlineDoctor.com, for some, a lack of access and transparency, high costs, discrimination, and misdiagnoses have created an environment of distrust and avoidance of doctors in America.

“Personalized care is an often overlooked aspect of healthcare that patients want and deserve,” says OnlineDoctor.com spokesperson Mitchell Fong. “The following data shows very different perspectives for patients across social determinants. However, what is consistent is that patients want personalized care they can trust, access, and afford. Understanding the patient is one way to improve meaningful relationships with patients and lead to the improved quality care patients want and need.”

Key Findings

  • While 43% of all Americans trust a doctor of their own race more than a doctor of another race, 67% of Black Americans trust Black doctors more
  • 18% of Americans haven’t seen a doctor in 5 years or more
  • 34% of Americans cite poor insurance coverage and high co-pays as the main reason why they avoid doctor’s appointments.
  • 23% of Americans express mistrust of their primary care physician

Eighteen percent of American adults haven’t visited a doctor in five years or more.

Women are more likely than men to have had a doctor’s appointment within the last year, by a margin of 20%. Men are almost three times as likely as women to have gone five years or more without a doctor’s appointment.

Seventy-eight percent of people 54 and older visited a doctor within the last year, a much higher percentage than people of any other age group. Meanwhile, 10% of people ages 35-44 haven’t had a doctor’s appointment in 10 years or more.

When asked how they feel about doctor’s appointments, the majority of respondents say they like them, citing the peace of mind and professional feedback they get from routine check-ups. However, 14% of Americans say they do not like visiting the doctor, with 5% saying they will only seek medical attention if it’s a life-threatening emergency, citing, among other reasons, expensive co-pays due to poor insurance coverage, and a lack of trust in medical professionals based on a past misdiagnosis.

The high cost of medical care in the U.S. is often cited as a barrier, an issue supported by our survey. Nineteen percent of people who earn between $25,000 and $49,999 annually say they dislike going to the doctor because of the cost, compared to only 4% of people who earn $150,000 or more annually.

23% of Americans express mistrust of their primary care physician

According to our survey, 76% of Americans have a primary care physician, while 15% rely on emergency rooms or urgent care centers, and 6% do not seek traditional medical attention.

Of those individuals who do have a primary doctor, 8% do not trust their doctor, while 15% can’t decide if they do or not.

The indecisiveness about whether to trust their primary care physician is highest among Black and Hispanic respondents, who chose “undecided” at a rate of 18% and 20%, respectively. However, 9% of both Black and White respondents say outright they do not trust their primary care physicians, compared to 4% of Hispanic individuals.

The youngest and oldest individuals we surveyed are the most likely to express distrust of their primary care physicians. Eleven percent of both 18-24 year-olds and people 54 and older said they do not trust their primary doctor, compared to just 5% of 25-34 year-olds, 9% of 35-44 year-olds, and 7% of 45-54-year-olds. However, nearly one quarter, 23%, of 25-34 year-olds are undecided, compared to 13% of 35-44 year-olds.

More than 1/3 of people don’t trust their doctor because they think they are underqualified

When asked to identify the reasons why they do not trust their primary care physician, the most-cited reasons are cost and a belief that their physician is underqualified. Each reason was selected by 36% of respondents. That percentage is nearly double for people 54 and older, 60% of whom feel their doctor is under-qualified.

For all respondents, the other most-cited reasons for a lack of trust in their primary care physician include recommending unnecessary procedures (30%), rudeness (24%), local public perception (22%), and over-prescribing medication (20%).

Women are twice as likely as men to say that their primary care physician is rude to them, by a margin of 32% to 16%. Meanwhile, men are twice as likely as women to say that they don’t trust their doctor because of poor hygiene, by a margin of 16% to 8%, and a lack of professional attire, by a margin of 20% to 8%.

When examined by ethnicity, Hispanic patients are twice as likely as White patients to say their primary care physician is rude to them. Meanwhile, 42% of White patients said their mistrust of their primary care physician comes from feeling like their doctor is under-qualified, compared to 20% of Black patients.

1/3 of Americans don’t trust their doctor but have no other choice

So if people have such a laundry list of reasons why they don’t trust their primary care physician, why do they continue using their services? Our survey found that a lack of other options is the main reason why people do not switch doctors.

Thirty-four percent of survey respondents say their current practitioner is the only option in their geographic area, while 18% also say their doctor is the only option within their insurance network. Twenty-eight percent of respondents say a lack of motivation to change physicians keeps them returning to the same doctor, while “loyalty” and “cheapest option” each got a 22% share of responses.

Loyalty is a bigger factor for older individuals, who may have years or decades of history with their primary care physician. Fifty percent of people 54 and older say this is why they remain with their primary doctor, compared to 29% of people 18-24 years old.

67% of Black Americans express more trust in Black doctors

The relationship between BIPOC communities and the American healthcare system has a documented history of inequality and discrimination. However, no Black or Hispanic respondents to our survey report facing racial discrimination from their doctors, while 6% of White respondents say they have experienced racial discrimination.

When asked if they trust a doctor of their own race more than a doctor of a different race, 43% of all respondents say they do. That percentage was far higher for people of color: 67% of Black respondents, and 57% of Hispanic respondents say they trust doctors of their own race more, compared to 39% of White respondents.

Regardless of race, older Americans are less likely to say they trust a doctor of their own race more, with only 28% of people 54 and older answering “yes” to this question, and 52% saying “no.” Comparatively, 52% of 18-24 year-olds say they do trust a doctor of their own race more, while 27% do not. Younger Black and White Americans are most likely to hold this opinion; 38% of respondents who chose this answer are Black, and 29% are White.

Nearly ¾ of women under 25 trust female doctors more

Gender discrimination is another issue individuals face when seeking medical attention, with 10% of both men and women saying they avoid doctor appointments for this reason. Additionally, 21% of women and 16% of men say they have experienced body-shaming by doctors, which also contributes to their mistrust and hesitancy to seek medical care.

These issues may be contributing factors in why 50% of women and 54% of men say they trust a doctor of their own gender more.

Age and ethnicity also appear to have an impact on an individual’s preferences for their doctor’s gender. Younger women are more than twice as likely as older women to say they trust a female doctor more, with 72% of women 18-24 indicating this preference, compared to 28% of women 54 and older. Meanwhile, 75% of Hispanic women, and 67% of Black women say they trust female doctors more, compared to 41% of White women.

Sixty percent of men 18-24 trust a male doctor more, compared to 31% of men 54 and older. Along racial lines, men have similar preferences: 57% of Hispanic men, and 56% of both White and Black men say they trust a male doctor more.

Low-income earners twice as likely to rely on ERs for medical care

Across income brackets, people who earn less are more likely to say they do not have a primary care physician, and that they rely on urgent care centers and emergency rooms for medical attention.

Eight percent of people who earn $150,000 or more annually said they use ERs and urgent care, compared to 17% of people who earn less than $25,000 annually, and 16% of people in both the $50,000-$99,999, and $100,000-$150,000 income brackets.

Overall, 6% of survey respondents say they do not seek traditional medical attention. This percentage doubled among 18-24 year-olds (12%), and Black Americans (11%).

1/3 of Americans avoid regular doctor appointments because of poor insurance coverage, expensive co-pays

Money, time and trust are the most-cited reasons why people do not like visiting the doctor.

Thirty-four percent of survey respondents say they avoid the doctor because of expensive co-pays due to poor insurance coverage, while 29% say they have no health insurance, and can’t afford out-of-pocket costs.

Meanwhile, 30% of respondents say they do not trust doctors after multiple misdiagnosis, and 19% of people cite a general lack of trust in medicine, and preference for natural remedies. Twenty percent of respondents indicate they are fearful of finding out an illness is life-threatening, while 19% also say they fear contracting a separate illness at the doctor’s office. Nearly one-quarter of respondents, 22%, say they can’t get time off work to attend doctor’s appointments.

Methodology

The data from this report comes from an online survey created and paid for by OnlineDoctor.com. The survey was administered by online survey platform Pollfish on March 25, 2021. We surveyed 600 Americans aged 18 and older about their feelings towards doctor visits in general, and their primary care physician specifically, including reasons why they do not trust their primary care physician, and why they do not attend doctor’s appointments routinely.

Full Survey Results

Q1: Approximately, how many years has it been since you visited a doctor?

  • 1 or less: 60%
  • 2: 10%
  • 3: 5%
  • 4: 5%
  • 5: 3.5%
  • 6: 3%
  • 7: 1%
  • 8: 2%
  • 9: 1%
  • 10: 1.5%
  • 10 or more: 6%
  • I’ve never visited a doctor: 2%

Q2: Do you have a primary care physician?

  • Yes: 75.5%
  • No, I rely on urgent care, ER, etc.: 14.5%
  • No, I don’t seek traditional medical attention: 6%
  • Other: 4%

Q3: Which of the following most closely describes your relationship with doctor visits?

  • Like a lot: 29%
  • Like: 28%
  • Neutral: 26%
  • Dislike: 9%
  • Strongly dislike: 5%
  • Other: 3%

Q4: Why don’t you like visiting the doctor? Please select all that apply.

  • Lack of trust in health care due to multiple misdiagnoses in the past: 30%
  • General lack of trust in medicine/prefer natural remedies: 19%
  • No insurance/ can’t afford out-of-pocket costs: 29%
  • Expensive co-pays due to poor insurance coverage: 34%
  • Fear of contracting a separate illness while there: 19%
  • Lack of respect from staff: 12%
  • Fear of disclosing personal information: 13%
  • Fear of finding out an ailment is life-threatening: 20%
  • Racial discrimination: 5%
  • Gender discrimination: 10%
  • Body shaming: 19%
  • Lack of knowledge on how to schedule an appointment: 7%
  • Can’t get time off work: 22%
  • Other: 18%

Q5: Do you trust your primary care physician?

  • Yes: 77%
  • No: 8%
  • Undecided: 15%

Q6: Why do you not trust your primary care physician? Please select all that apply.

  • Under qualified: 36%
  • Gender, race, or ethnicity: 18%
  • Public perception: 22%
  • Always late: 18%
  • Past misdiagnoses: 16%
  • Rude: 24%
  • Poor hygiene: 12%
  • Lacks professional attire: 14%
  • Over prescribes medication: 20%
  • Recommends unnecessary procedures: 30%
  • Cost: 36%
  • Other: 14%

Q7: Why do you continue to use your primary care physician’s services? Please select all that apply.

  • Only option in my area: 34%
  • Cheapest option: 22%
  • Only option in my insurance network: 18%
  • Lacking motivation to change: 28%
  • My doctor is family/friend: 16%
  • Loyalty: 22%
  • None of the above: 24%

Q8: Do you or would you trust a doctor of your own race more?

  • Yes: 43%
  • No: 37%
  • None of the above: 20%

Do you or would you trust a doctor of your own gender more?

  • Yes: 52%
  • No: 32%
  • None of the above: 16%