Salient issues in choosing a new doctor

Abstract

In this paper we argue that selecting a new doctor is one of three phases in the overall, iterative process of patient-practitioner encounters. Further, we assume that the factors which impact on individuals' decisions to seek and to use health services should also influence their choices of new physicians. Accordingly, we assess the extent to which traditional predictors of health services utilization (i.e. the predisposing, enabling, illness-morbidity, and consumer satisfaction characteristics) are directly associated with individuals' identifications of the important factors in their choices of new doctors. Discriminant function and multivariate contingency analyses of data from a national survey of 1530 adults reveal five major patterns of typical behavior. First, individuals with lower socioeconomic status and poorer access to medical care choose the psychosocial aspects of the patient-practitioner relationship as most important in selecting a new doctor. Second, individuals with lower socioeconomic status but better access to medical care focus on the cost of an office visit. Third, individuals with higher socioeconomic status but poorer access to medical care focus on the hospital affiliation of the physician. Fourth, individuals with higher socioeconomic status and better access to medical care focus on the physician's affiliation with a medical group. Fifth, individuals with higher socioeconomic status and moderate access to medical care focus on the recommendation of friends. Finally, we discuss the implications of these behavioral patterns for models of health services utilization, consumer satisfaction, the sick role, and medical school curricula and recruitment policies.