8 in 10 women delay care until their symptoms worsen, survey finds. This is bad for patients and employers

About 8 in 10 women say they are delaying care until their symptoms worsen or affect their daily lives, and 43% have recently missed a day or more of work due to health issues.

These health trends are bad for women and also for their employers.

Primary care provider Parsley Health commissioned a survey of 1,200 full-time employed, insured women ages 18 to 60 to uncover their top health concerns and care challenges. The biggest takeaway? For many women, their healthcare needs have been left behind by a system that has largely ignored the broad, intersecting and complex health needs women experience across their lifetimes, Robin Berzin, M.D., founder and CEO of Parsley Health, said during an exclusive interview to review the survey results.

A recent Deloitte analysis found that employed women face as much as $15.4 billion more each year in out-of-pocket costs compared to men. Across all ages between 19 and 64, women's out-of-pocket expenses were higher on average, according to the report. But only a portion of that can be attributed to maternal care needs. Women experience 10% more in total health expenditures relative to men when excluding maternity claims, the Deloitte analysis, based on Komodo Health data, found.

"A lot of the research that we see have these big stats with billions of dollars and huge percentages of the population can sometimes obscure what a human being's true experience of their health in their day-to-day life looks like. That was the impetus to do this survey," Berzin said.

Almost half of women surveyed say their health issues have affected their work productivity in the past 60 days. The top issues that led to those missed days include fatigue or lack of sleep, headaches/migraines, infection, mental health, physical pain or stomach/digestive issues.

The survey indicates that a large percentage of women put off seeking care, and this leads to delayed or missed diagnoses. When asked why they delay care, 44% said they don’t have time to make an appointment or go to the doctor, 34% delay care because they are discouraged by previous experiences at the doctor and/or do not feel like their doctor has helped them resolve their symptoms and 33% pointed to the cost of visit and/or copays.

What's more, 24% delay care because they worry they will just be prescribed more medication—which they do not want.

"These are factors that we all can relate to, but these are factors that we dismiss as surmountable, and this report indicates that these factors are not insurmountable and that we have a real problem," she said. "Not having time to go to the doctor is a big issue. I think in a world where telehealth has become more normalized, we've forgotten that not everybody has that option. Time poverty is a real issue for women, that time to just see a doctor. Also, experiences with providers and feeling dismissed or unheard or not getting the answers they're looking for is a huge factor."

Women make up about 60% of the workforce, and employers need to step up to help fills these gaps in care to reduce costs and absenteeism while helping solve the real issues that women face, Berzin noted.

Three-fourths of Parsley Health's patients are women, and Berzin feels that her company is treating many women who have not been supported by the traditional healthcare system.

"Women are disproportionately impacted by a lot of today's most common chronic conditions, and women come to Parsley just to solve those problems," she said.

Berzin launched Parsley Health in 2016 to offer a unique approach to primary care centered on root cause resolution medicine. The idea is to focus on the source of a medical issue rather than the symptoms, she noted.

A physician trained at Columbia University and Mount Sinai, Berzin set out to launch a medical startup to address primary care gaps for women and families. The company offers virtual-first medical services nationwide through telehealth visits. It also operates brick-and-mortar clinics in New York and Los Angeles. The clinics are designed to look nothing like a typical doctor's office—Parsley’s lobbies look more like a boutique hotel or a day spa.

The primary care provider is designed to be a medical home base for patients’ complex health needs—treating and preventing multiple conditions at once including autoimmune, gastrointestinal, cardiometabolic, hormonal and mental and behavioral health. The provider also supports reproductive health including preconception, fertility, pregnancy, postpartum and menopause. 

Parsley Health's survey found that about two-thirds of women say they are having issues with getting a clear diagnosis—of which 25% are still waiting for diagnosis or gave up entirely.

"This is the population that we see often at Parsley, where we're doing what I call the 'investigative journalism' of healthcare, where we're digging in to figure out what they have. That population actually has a chronic condition; it's just that they haven't been diagnosed yet, or it's been misdiagnosed, or no one's given it a name," she noted.

Employers often do not focus on this "rising risk" population, Berzin said.

"The survey findings indicate that there's a lot of people who are sick but don't know why they're sick," she said. "When we think about employer-sponsored healthcare, there tends to be a focus on the people who, last year or the year before, had claims or had certain things and conditions that we already know about. But there's not always an avenue to address the people who are missing work, who don't feel well, who have a constellation of symptoms or maybe have more than one condition but who don't necessarily know what they have.The message is, there is a lot more people, particularly women, who are sick and missing work and delaying care."

When asked what they wanted from their healthcare benefits, women most often reported wanting comprehensive support from one doctor who can treat their unique health needs without requiring multiple specialist referrals, according to the survey. Women also said they want more solutions for their specific health concerns and better care management services that coordinate care.

The women surveyed said they want healthcare service that caters to their schedule and time limitations, offers a clear diagnosis without multiple specialist referrals and focuses on the root cause of conditions are identified and treated.

Parsley Health released the survey as the company has been ramping up its focus on building out its enterprise business in the past year. In May, the company rolled out a women's health program available to self-insured employers and plan sponsors. The program is designed to offer coordinated medical care for a range of chronic conditions and health needs.

According to the survey, 71% of women say they would leave their current job for better healthcare benefits.

Employers need to offer more comprehensive support for a wide range of women's health issues, Berzin said.

"Women's health is not just reproductive health. Women's health is autoimmune disease and women's health is gastrointestinal health and it's behavioral health, where women have different needs and different types of solutions they might respond to better than others," she said. "Also, we need to meet people where they are so solutions that are close by or telehealth-based, right, so they don't require people to travel long distances or to take time out of the work day. Time poverty has such a big impact, so investing in telehealth solutions that bring care into the home or the office or the place of work, I think is really critical."

She added, "And we need to recognize that people don't have the bandwidth for seven different solutions for different symptoms. What we've heard over and over again is that women want one place to go or a home base for a lot of their healthcare needs."

Parsley Health claims that by focusing on high-touch, tech-enabled virtual care combined with root cause resolution medicine, it has been able to improve or resolve symptoms for more than 85% of patients in the first year of care while also significantly reducing prescription drug usage and referrals to specialists. An independently validated analysis of 20,000 high-cost patients with chronic conditions showed a 2x ROI and a 32% reduction of medical spend within 24 months, according to the company. 

The company has grown rapidly this year. It has inked deals with major insurers in New York and California to reach 10 million patients as an in-network service.

"A year ago, we were just launching our first employer. We will be in double digits for employers by January 1, so we are really seeing an incredible growth curve across employers. We're in progress with health plans toward our first value-based contracts, which is really exciting for me. I started Parsley Health back in 2016 believing that the tailwinds behind value-based care were beginning to blow and would ultimately blow strong enough that there would be ways for Parsley to interact with the system in that way," she said.

Parsley Health has raised over $100 million to date and completed its series C funding round in 2021.

Parsley Health currently works with "tens of thousands of members" across the country, according to Berzin.