Why People Avoid Getting the Medical Care They Need: Uncovering the Barriers

Apr 24, 2024

It’s a common and concerning phenomenon: many people avoid seeking medical care even when they suspect they should. This avoidance can have serious consequences, from delayed diagnoses to untreated illnesses that worsen over time. So why do people put off doctor visits that could potentially save their lives or greatly improve their well-being? As it turns out, the reasons are numerous and complex, but they generally fall into three main categories: low perceived need for care, traditional barriers to access, and unfavorable evaluations of seeking medical care. By understanding these obstacles, we can develop strategies to help people overcome them and get the care they need. Discover Health Advocacy offers medical navigation assistance to address these issues, guiding individuals through the healthcare system to ensure they receive timely and appropriate care.

Low Perceived Need for Medical Care

One of the most prevalent reasons people avoid medical care is that they simply don’t believe they need it. This low perceived need can manifest in several ways:

Beliefs That Symptoms Will Improve

Many people avoid going to the doctor because they assume their health problems will just go away on their own. In one study, over half of participants who avoided care cited “expected symptom improvement” as a reason. People often take a wait-and-see approach, hoping that troubling symptoms are just temporary blips that will resolve themselves with time.

This belief is especially common when symptoms seem mild or vague. A persistent cough, for example, might be brushed off as “just allergies.” Recurring pain could be chalked up to getting older or sleeping wrong. It’s understandable to hope that health issues will go away without intervention, but some symptoms may indicate serious underlying conditions that require prompt medical attention.

Not Feeling “Sick Enough”

Even when symptoms don’t improve, some people still avoid care because they don’t feel their condition is severe enough to warrant a doctor visit. They may compare themselves to others who seem sicker and conclude that their own health problems aren’t bad enough to seek help.

This mentality is captured in responses like: “I only go if I think it’s serious” or “I’m not sick enough to go to the doctor.” The trouble is, laypeople aren’t always equipped to judge the seriousness of medical symptoms. What may seem like a minor nuisance could be an early warning sign of a significant issue. Delaying care until a condition feels “bad enough” could allow health problems to worsen unnecessarily.

Preference for Self-Care and Alternatives to Medicine

Another subset of people feel they don’t need professional medical care because they prefer to handle health issues on their own or use alternative approaches. Some try to self-treat with over-the-counter medication, while others turn to home remedies or natural cures.

In certain cases, people prefer to rely on spiritual healing or believe their higher power will heal them without human intervention. And a small proportion of people, including some medical professionals, feel they don’t need doctors because they can diagnose and treat themselves.

While self-care and alternative therapies can be helpful complements to professional care, they are not always sufficient substitutes – especially for serious or chronic conditions. Believing you can manage health problems independently may offer a sense of control, but it can also cause you to underestimate the level of care you really need.

Low Perceived Need for Medical Care

Traditional Barriers to Access

Even when people do perceive a need for medical care, they often encounter obstacles that limit their ability to obtain it. These traditional barriers to healthcare access take many forms:

High Costs and Inadequate Insurance

It’s an unfortunate reality that medical care can be prohibitively expensive, especially for people with limited financial resources. In a recent survey, nearly one-third of Americans cited cost as a reason they had avoided the doctor.

Out-of-pocket payments, such as copays and deductibles, can quickly add up – particularly for those with high-deductible health plans. Even with insurance, people may find themselves unable to afford recommended tests, treatments or medications.

The un- and underinsured face even greater challenges in accessing care. Despite expansions in insurance coverage in recent years, significant gaps remain. People without comprehensive coverage often avoid preventive and routine care, only seeking help when health issues become dire.

These financial barriers have ripple effects that extend beyond immediate care. People with limited resources may struggle to take time off work for appointments. Those already facing economic hardship may find themselves choosing between medical bills and basic necessities like food and housing.

Time Constraints and Inconvenience

In our fast-paced world, many people simply feel they don’t have time to go to the doctor. Busy work schedules, family responsibilities and competing demands can make it challenging to prioritize medical visits.

Inconvenient clinic hours pose an additional roadblock, especially for those with conventional work schedules. Taking time off for an appointment may mean losing wages or using limited paid time off. For hourly employees and those with inflexible jobs, that’s often a difficult tradeoff.

Even when people do make time to see a doctor, they may face long wait times for available appointments. Urgent health concerns might not be accommodated quickly, leading some to conclude it’s not worth the hassle to be seen.

Convenient alternatives, like telemedicine and retail clinics, have arisen to mitigate some of these challenges. But time pressures and scheduling difficulties remain a stubborn barrier that keep many from getting prompt and consistent care.

Traditional Barriers to Access

Transportation and Mobility Issues

Just physically getting to a doctor’s office can be a barrier, particularly for people with limited transportation and mobility. Individuals who don’t drive or lack access to a vehicle may have to rely on public transit systems that can be unreliable, time-consuming or costly. In rural areas, the nearest clinic may be a long distance away, compounding transportation difficulties.

For people with physical limitations, even getting to and navigating medical facilities can be daunting. Some avoid care because of the sheer effort involved in getting out of the house and to the provider’s location.

Telemedicine has provided a helpful alternative for some, but it’s not a universal solution. Internet access and comfort with technology can be additional barriers, especially for older adults and low-income populations. Ultimately, the physical obstacles to reaching care sites remain a challenge for many.

Language Barriers and Lack of Childcare

Language and communication issues can also impede access to care. For individuals with limited English proficiency, trying to navigate the complexities of the healthcare system can be overwhelming. While some clinics offer language services, miscommunication and misunderstanding can still occur, leading some to avoid care entirely.

Parents of young children face a different kind of challenge: finding childcare so they can attend their own medical visits. For single parents and low-income families, paying for a babysitter or taking children to the clinic may not be feasible.

Some innovative clinics have sought to ease this burden by providing on-site childcare during appointments. But this service is far from widespread, and lack of childcare remains an understated but significant reason parents – especially mothers – may delay or avoid getting care for themselves.

Unfavorable Evaluations of Seeking Medical Care

Sometimes, people perceive a need for medical care and have the means to access it – but still avoid going because they hold unfavorable views of the process or outcomes of seeking care.

Poor Doctor-Patient Communication and Mistrust

Negative perceptions of doctor-patient interactions are a key reason some people avoid seeking care. Communication issues are a common complaint, with people citing experiences of physicians not listening to them, not taking their concerns seriously, or not explaining things clearly.

When patients don’t feel heard or respected by their doctors, it erodes trust in the provider and the medical system overall. People may come to doubt whether physicians have their best interests at heart and whether they can rely on their guidance.

This mistrust can be heightened for groups with histories of medical mistreatment, such as racial minorities and people with disabilities. Past negative experiences with biased or dismissive care can make individuals hesitant to engage with providers again.

Repairing and strengthening doctor-patient relationships is key to mitigating this barrier. Providers must prioritize empathetic, clear communication and take steps to build trust with patients and communities. Only by feeling respected and supported will people feel comfortable consistently seeking care.

Perceived Low Quality of Care

Even if they don’t doubt physicians’ intentions, some people avoid care because they worry about the quality of services they’ll receive. They may fear being misdiagnosed, or that their doctor won’t be able to identify the cause of their symptoms.

This perception can be fueled by prior experiences of misdiagnosis, either personally or by family and friends. Sensationalized stories of medical errors in the media may also stoke anxiety about clinical competence.

In some cases, concerns about quality are well-founded, as not all medical providers are equally skilled or up-to-date on best practices. People in underserved communities may have access to fewer high-quality providers, giving them legitimate reasons to question the caliber of care they’ll receive.

Overcoming this barrier requires both individual providers and healthcare systems demonstrating a commitment to high reliability and continuous quality improvement. The more people feel confident they’re in capable hands, the more motivated they’ll be to seek those hands out.

Anticipated Negative Emotions

For some people, the prospect of seeing a doctor evokes negative emotions strong enough to deter them from going. Anxiety and fear are common culprits; some people intensely fear things like potential bad news, medical instruments and procedures, or even doctors themselves.

Embarrassment is another oft-cited reason for avoidance, especially when health issues involve stigmatized conditions or intimate body parts. The idea of discussing sensitive topics like sexual or mental health can be cringeworthy enough to keep people from seeking help.

Even feelings of guilt can be a deterrent. Some people avoid doctors because they anticipate feeling judged or shamed about unhealthy habits and lifestyle choices. Rather than face those difficult conversations, they opt out of visits entirely.

Destigmatizing health issues and creating judgement-free clinical environments are important steps in reducing emotional barriers to care. So is increasing mental health awareness and treatment, so people are better equipped to cope with anxiety and distress.

Dislike of Medical Recommendations

Finally, some people steer clear of doctors because they don’t want to hear their advice. They expect to dislike diagnostic tests, prescribed medications and unpalatable lifestyle changes.

Resistance to behavior changes like losing weight, exercising more and improving diet can run especially deep. Defensiveness and frustration at physicians “nagging” them about their health can build over time, to the point that it feels easier to just avoid those conversations entirely.

Concerns about medication side effects and risks can also feed reluctance to engage with care. And some people simply don’t like being told what to do, even by medical authorities.

To combat this phenomenon, providers walk a fine line between informing and partnering with patients on their care. Motivational interviewing and shared decision-making are counseling techniques that can help patients feel more empowered and on-board with treatment recommendations. But the hard work of behavior change ultimately falls on the individual, and their willingness to participate is key.

Unfavorable Evaluations of Seeking Medical Care

A Conceptual Model of Medical Care Avoidance

The reasons people avoid medical care are numerous and interwoven, but they can be broadly organized into three sequential categories:

  1. Low perceived need: People don’t seek care because they don’t believe they have a health issue that warrants medical attention.
  2. Traditional barriers to access: People perceive a need for care but encounter obstacles that directly limit their ability to obtain it, like cost and transportation.
  3. Unfavorable evaluations of seeking care: People perceive a need for care and have the ability to access it, but hold negative views of the process that deter them from going.

This progression closely mirrors the three core constructs in Crisis Decision Theory, a general model of how people respond to negative events:

  1. Appraisal of the severity of the threat
  2. Assessment of available response choices
  3. Evaluation of the response options

People who see no threat from their symptoms won’t engage in care-seeking, just as those who perceive no good options won’t pursue them. Only those who appraise a sufficient health threat, identify care-seeking as an available response, and evaluate that response favorably will decide to obtain care.

This model can help identify intervention points to increase appropriate care-seeking. For instance:

  • Education on warning signs and the importance of early detection could prompt more people to appraise their symptoms as a legitimate reason to see a doctor.
  • Expanding insurance coverage and clinic hours could increase people’s perception that seeking care is a viable option for them.
  • Improving patient experiences and doctor-patient communication could lead more people to evaluate care-seeking as worthwhile.

By targeting the key decision points in care avoidance, we can help people get the care they need at each stage of their symptom evaluation and decision-making process.

Overcoming Care Avoidance with Discover Health Advocacy

The reasons people avoid needed medical care are complex and multilayered, ranging from financial to emotional to practical. But by understanding the key factors that fuel care avoidance, we can develop better strategies to help people overcome those barriers.

There is no one-size-fits-all solution, as the precise blend of reasons will vary from person to person and across different populations. A low-income person without health insurance may avoid care for very different reasons than an insured professional who distrusts doctors. The unique mix of obstacles matters.

But some broad approaches – like expanding insurance coverage, increasing accessibility of services, improving patient-provider relationships and targeting education campaigns to individuals with low perceived need – could go a long way in reducing avoidance and connecting more people to care.

Enabling people to get timely, appropriate medical care is a public health imperative. Every avoided doctor visit is a missed opportunity to detect and treat conditions and improve quality of life. By striving to understand patients’ lived experiences, we can design a healthcare system that better meets their needs – and convince them to walk through the clinic doors.

So if you’ve been putting off seeing a doctor, take a moment to reflect on what’s holding you back. Are you not sure if your symptoms warrant a visit? Have you had trouble finding the time or money to go? Do you have concerns about what the doctor will say or how you’ll be treated? Pinpointing your own personal barriers is the first step.

Then, explore your options for getting the care you need. Discover Health Advocacy can help you find affordable clinics, navigate insurance issues, access transportation assistance and advocate for the support you require. Don’t let fear, overwhelm or uncertainty keep you from taking charge of your health. You deserve to feel your best – and we’re here to help you get there.