Consultations with primary care doctors are for many people the most frequent contact with health services, and often provide an entry point for subsequent medical treatment. Consultations take place in doctors’ clinics, community health centres, hospital outpatient departments or, in some cases, patients’ own homes. Increasingly, teleconsultations are offered to patients, whereby consultations take place online, often through video calls.
In 2023, the average number of annual in-person doctor consultations per person among OECD countries ranged from fewer than 3 in Mexico, Costa Rica, Sweden and Greece to 18 in Korea (Figure 5.16). The OECD average was 6.5 consultations per person per year. In Canada, Finland, Sweden, the United Kingdom and the United States, the relatively low number of consultations can be explained in part by the enhanced role that nurses and other health professionals play in primary care – notably in management of patients with chronic diseases and in dealing with patients with minor health issues. This lessens the need for doctor consultations (Brownwood and Lafortune, 2024[1]).
The number of in-person consultations has decreased in 21 of 31 OECD countries since 2019. This can be attributed in part to increased use of teleconsultations in recent years. Indeed, in 2023, 13% of all doctor consultations were teleconsultations, on average across 22 OECD countries with comparable data (Figure 5.17). Teleconsultations comprised over 25% of all doctor consultations in Denmark, Estonia, Israel, Portugal and Sweden, but remained very low in Chile, Germany, Greece and Korea (see the section on “Data and digital” in Chapter 9 for trends in teleconsultations).
Provider payment methods and levels of co-payments have an impact on the number of doctor consultations. In some countries, doctors are paid predominantly by fee‑for-service (as in Germany, Japan, Korea and the Slovak Republic). Such countries tend to have higher consultation rates than those countries where doctors are mainly paid by salaries or capitation (such as Denmark, Finland, Mexico and Sweden). Still, in the United States, doctors are paid mainly by fee‑for-service, but consultation rates are relatively low. This may reflect in part the high co-payments faced by a large proportion of the population, which can cause patients to not consult a doctor because of the cost of care.
The number and type of doctor consultations can vary among different socio‑economic groups. Wealthier individuals are more likely to see a doctor than individuals in the lowest income quintile, for a comparable level of need. Income inequalities in accessing doctors are much more marked for specialists than for GP consultations (OECD, 2019[2]).
Information on the number of doctor consultations per person can be used to estimate the annual number of (in-person) consultations per doctor. This indicator should not be taken as a measure of doctors’ productivity, since consultations vary in length and effectiveness, and because it excludes services doctors deliver for hospital inpatients, as well as time spent on research and administration. Keeping these comparability issues in mind, the estimated number of consultations per doctor is highest in Korea, while Japan and Türkiye also reported high numbers of over 4 500 in 2023 (Figure 5.18). In Korea, this can be explained in part by short consultation times, allowing doctors to treat more patients per session, and seen by the government as a way of keeping waiting times low, with most patients able to receive primary medical care on the same day, even without an appointment. Numbers were lowest in Greece and Sweden. In Sweden, consultations with doctors in both primary care and hospital settings tend to be focussed on patients with more severe and complex cases.
