A default doctor’s appointment?

The NYT opened up a forum for people to submit ideas on default rules that could be changed. One idea, proposed by a reader in “KC”, that Tina Rosenberg found interesting was around health care appointments.

“When signing up for a health plan, it might be effective to have to opt-out of preventive treatments, such as an annual checkup. I never went for my annual checkup when I was younger because it required researching a doctor and scheduling an appointment. I would have gone to a checkup if I was given a default doctor and had an appointment scheduled for me.”

Choosing a doctor can be a personal choice, which seems like a good reason for resisting switching this default rule for some. But HMO plans have made medicine far more impersonal than it was a generation ago. And with people moving to new cities and need to find new physicians, it might be a default rule switch worth looking into for some patients. The default rule switch need not be some elaborate set up taking into account various preventative procedures. It could be as simple as this: When you sign up for a new health plan, a primary care physician close to your work or home is chosen for you and one appointment is scheduled within the coming few months. You are provided with a number to call to cancel the appointment or to switch doctors.

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  • Steve

    The power of this concept became evident to me b/c of my dentist.

    I never missed a dentist appointment until the one day my dentist called to cancel my next appointment. They let me hang up without rescheduling a new one (I said, I’ll call to reschedule later)…

    10 years went by before I got around to going to the dentist again.

  • Jeff

    I’m not sure I like this idea, though it probably would increase the amount of annual checkup visits. McKenzie et al. 2006 makes a convincing case that policy defaults are construed as recommendations of the policy-maker. While I certainly would recommend a friend sign-up for their company’s 401k, I wouldn’t recommend he visit a _particular_ doctor without knowing anything about him. Some doctors are better than others, and some doctors are just not a good fit for certain people. If the patient goes to the visit and leaves unsatisfied, he’s very likely to experience a contrast effect and avoid doctors altogether.

    Not saying that the default would be a horrible idea, but I wouldn’t advise it without some thorough testing.

  • http://twitter.com/kurtmunz Kurt Munz

    This totally works. I’m in the military. They tell me when I’m due. I go. Every time.

    • http://www.nudges.org/ Nudge blog

      Interesting. Can you elaborate more, Kurt? Does the military make all your doctor’s appointments? Just the first one? Do they do this even if you’re not on active duty?

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