If you have a friend or loved one who can’t remember the last time they had a doctor’s appointment, they might justify it by saying they never get sick or don’t have any risk factors. Even if they are generally healthy, that doesn’t mean they should skip out on a regular doctor’s visit for preventive care.
If you encourage them to visit the doctor and are met with defensiveness or the conversation gets shut down, it’s important to consider what else might be going on in your loved one’s life that could be preventing them from seeking care—even when they need it.
They Are Afraid of What Medical Care Might Cost
The cost of healthcare—including the perceived costs of healthcare—drives many people away from the treatment or preventive care they may desperately need. Even in the age of the Affordable Care Act (“Obamacare”), people who are insured still face barriers to obtaining quality coverage and care. This impacts how and when they access healthcare.
According to a 2019 report from the St. Louis School of Medicine:1
- Many healthcare plans come with high deductible or out-of-pocket costs that exceed the income of policyholders and dissuade them from seeking care.
- Insured people with chronic medical conditions in need of ongoing care will frequently delay or avoid accessing care due to the fear of high costs.
- Individuals who assume that costs are unaffordable will often delay or avoid care and will only seek treatment when they are very ill and have no other choice.
A person’s income contributes a lot to these perceptions, but not entirely. While 26.1% of people who earn less than $25,000 per year delayed or avoided care due to real or perceived costs, nearly the same percentage of people who earn $50,000 to $75,000 per year (25.1%) did the same.1
Overall, roughly one in five insured people (20.9%) avoided preventive care or treatment because of cost. Not surprisingly, the percentage was far higher among uninsured people (79.1%).1
This largely explains why people who live below the poverty line in the United States are at more than double the risk of death than those who live above the poverty line.2
They Don’t Understand Their Health Risks or Know About the Benefits of Preventive Care
If someone is generally in good health (especially when they’re young) they may not see the point in going to the doctor. People who are “healthy as a horse” may go years, if not decades, without seeing a medical professional.
If this sounds like your loved one, they may not realize that regular preventive care is actually one of the best ways to stay healthy.
Preventive health care promotes better health by empowering patients, making it valuable for everyone regardless of their state of health.
People are also often confused about what “risk” means in relation to their health. Some risks are visible and modifiable, such as smoking, but other types aren’t as obvious, like the impact of genetic or environmental risk factors.
For example, if someone is in good health and no one in their family has a serious illness, they might believe they are not at risk for a specific disease or condition. Likewise, if they have been working in a particular job for many years and have yet to experience any ill effects, they may assume that they never will.
They’re Embarrassed or Afraid
When asked directly about their health, people may respond defensively—especially if they feel that they are being judged. Someone’s health is a private matter that involves multiple personal decisions. Adults, in particular, may feel that they are being “coddled” or “nagged” when asked about health care.
Sometimes, a knee-jerk reaction is hiding an emotion your loved one is feeling just below the surface, such as fear, shame, or guilt.
Fear
People may resist going to the doctor out of fear. Some people have specific fears associated with doctor’s offices, hospitals, or medical procedures, such as needles. Other people just find the experience of generally anxiety-provoking.
Sometimes, a person may be reluctant to seek medical care, even when routine, out of the fear that they will be told something is wrong. They may refuse to have tests or screenings because they are afraid of receiving a difficult diagnosis or something else they perceive as “bad news.”
Embarrassment
Certain elements of a doctor’s visit can be embarrassing. Many people are uncomfortable being asked direct questions about their bowel habits or sexual activity—especially by a professional they don’t know or perhaps have only just met for the first time!
Needing to disrobe for a physical exam can also make a person feel vulnerable. Some exams, such as those of the breast and prostate, can be especially invasive.
People with a history of trauma may be especially reluctant, especially if they are afraid of re-experiencing their trauma.3
While an increasing number of healthcare providers are practicing trauma-informed care, your loved one may not be comfortable discussing their mental health needs. In fact, they may not even realize it’s a conversation they can, and should, have with their doctor.
Sometimes, a person may also feel embarrassed seeking health care even when they have symptoms. They may worry that they are just “being dramatic” or “making a mountain out of a molehill.” They may also be concerned a doctor will tell them their symptoms are “all in their head.”
They Lack Support and Resources
People struggling to access resources due to poverty, mental or physical disabilities, or other barriers may feel ashamed and demoralized when trying to interact with the healthcare system.
For example, uninsured individuals might believe they will be refused care.4 Those who have state-provided coverage may be afraid that they will be treated differently than someone with private insurance.
People may not seek health care because doing so would require asking for help, and they don’t want to be a burden to others. For example, a person who doesn’t have a car may not want to ask a friend for a ride to the clinic.
Work, school, and family commitments can also make it more difficult for someone to address their healthcare needs. If an appointment would require someone to take time off from work or school, they might fret about the time and money lost or be concerned about falling behind.
A person with small children or someone else at home that they take care of may not be able to keep an appointment if they don’t have someone to step in while they’re gone.
They Don’t Have a Doctor
Your friend or loved one might be willing, even eager, to see a doctor—they just don’t have one and aren’t sure where, or how, to find one. If they have complex health needs, they can easily become overwhelmed trying to determine what type of health care they need beyond a primary care doctor.
In some areas, local free clinics are available and can serve as community resources. Clinic staff and patient advocates can help navigate the system and meet healthcare needs.
However, these services aren’t available everywhere. People living in rural areas often have far fewer resources to choose from compared to people living in cities.5 In some cases, technology can help bridge the gap by connecting patients with clinicians via telehealth services.
A Word From Verywell
There are many reasons a person might not be able to go to the doctor—even when they need and want to do so. If your loved one hasn’t been to a doctor for a long time, you might want to encourage them—if not for specific symptoms, then for preventive care.
If you try to have the conversation and get shut down, consider that your loved one might be facing barriers to getting the care they need.
If there are ways you can help your loved one, such as offering support, providing transportation, or assisting with finding a doctor, let them know you’re ready and willing to lend a hand. Creating a calm and nonjudgmental environment to discuss these challenges will help you support your loved ones as they consider decisions about their current and future healthcare needs.
If your loved one isn’t responding right away, remember that it might take some time for your words to have an impact. Revisit the conversation at a later date. Also, remember that it’s ultimately your loved one’s decision to seek care.
It can be tough to accept this, but if they aren’t responding to your concerns after some time, there is only so much you can do. Your loved one needs to come to their own conclusions when it comes to their health.