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Doctors Having A Senior Moment

Older Americans going to the doctor's office in droves

MONDAY, July 30, 2001 (HealthDayNews) -- Older Americans' visits to the doctor's office have increased fairly dramatically over the last 15 years, a new government report says.

Americans went to a doctor's office more than 756 million times in 1999, the Centers for Disease Control and Prevention (CDC) says. But over the last 15 years, visits to family practitioners decreased by 25 percent while visits to specialists in internal medicine, heart disease and surgeons jumped by 40 percent.

The largest increase of those seeking medical help was by senior citizens, says lead researcher Catharine Burt, chief of the National Center for Health Statistics' (NCHS) ambulatory care statistics branch in Hyattsville, Md. "We are seeing that doctors visits are up about 20 percent for older Americans over the age of 65 in the past 15 years, and we are also seeing that doctors are prescribing and ordering more medications for all age groups."

Burt says the government surveys doctor's offices about ambulatory medical care visits "every year so that we can track changes in health care utilization. This survey was first done in 1973, and we began conducting it annually in 1985. This particular report highlights trends we've seen for the past 15 years."

Although older Americans are going to the doctor more, "about six times a year on average, people between the ages of 15 and 24 are going to the doctor's office less frequently than they did in 1985," Burt says.

The most frequent diagnosis is hypertension or high blood pressure, Burt notes, while upper respiratory infections, like a cold, and rheumatoid and osteo-arthritis are the other two most likely reasons for doctor visits.

Burt says the survey also looked at what medications doctors prescribed. "The most common generic substance prescribed by doctors is acetaminophen, the active ingredient in over-the-counter drugs like Tylenol. But we also looked at drugs recently approved by the U.S. Food and Drug Administration, and the most commonly prescribed drug among that group is Claritan, which is an allergy drug."

While an aging population accounts for the increased visits, "there's more than what you would expect from just aging," Burt continues. "If you had trended this information in 1985, you would have predicted more visits, but not this many. What's happening, I think, is that there are a lot of improved medications out there, and doctors are prescribing them more frequently. And because they are prescribing these medications more frequently and to more of their elderly patients, more doctors are asking patients to come back for follow up or to track their conditions."

The annual survey is important for the development of the U.S. health policy, says the American Academy of Family Physicians (AAFP).

"One of the take-home messages here is that this shows how important it is to have a survey like this, sustain it over time," says Dr. Larry Green, director of the Robert Graham Center, the policy arm of the AAFP in Washington, D.C. "This survey shows that the majority of the visits that people are making to doctors continues to be made to primary care physicians. Primary care physicians continue to be the core of the medical system in the U.S., and what's interesting is the primary care physicians represent about a third of the doctors in the United States. This survey makes it clear how valuable it is to have a medical home," Green says.

Improving the ability of the primary care physician to deliver quality medical care should be paramount, Green adds. "We should as a country be focusing more resources on the offices of primary care physicians. That includes training, establishing medical error systems, patient safety systems, electronic communications systems, web linkage systems, reminder systems for preventative services."

What To Do

For a closer look at the National Ambulatory Medical Care Survey, visit the National Center for Health Statistics. And for more on how to choose a primary care physician, see the American Academy of Family Physicians.

SOURCES: Interviews with Catharine Burt, Ed.D., chief, Ambulatory Care Statistics Branch, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Md.; Larry Green, M.D., director, Robert Graham Center, American Academy of Family Physicians, Washington, D.C.; Centers for Disease Control and Prevention
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