Medi-Cal Patients: How Do Physicians Compare Them with Other Patients?

In a survey of 1,400 physicians, opinions were solicited about overutilization of medical services by California's Medi-Cal (Medicaid) patients, in comparison with other patients. Nearly one-half of the physicians thought Medi-Cal and other patients overutilized to the same degree. But of the remaining half of the group, physicians reported Medi-Cal overuse five times as often as for other patients. Physicians reporting Medi-Cal overuse with greatest frequency were residents of less urbanized areas, graduates of Northern California medical schools, physicians who began practice since 1960, uncertified primary physicians, especially general practitioners, and, among specialties, general surgeons and certified obstetrician-gynecologists. No consistent pattern existed in variability of opinion about overuse by specialty, certification, and primary versus nonprimary physicians. Although an individual physician may be biased because of dislike of the Medi-Cal program or patients, if physicians as a group were biased, one would expect more uniformity of opinion. The conclusion is drawn that California's Medi-Cal patients do overutilize services more than other patients.