A new study shows Miami-area seniors use more than their fair share of health care services in general but less of one type of health care: primary care. The Dartmouth Atlas research group has previously noted Miami-Dade seniors consume more of the costly services provided by specialists, require more tests and spend more time in intensive care than in other parts of the country. Now research shows they see less of their primary-care physicians, which may explain their higher costs.

The tendency of seniors in Miami-Dade to rush to a specialist and their correspondingly higher health care costs seems to support claims made by Obama administration health care reformers that primary care helps reduce health care costs, in part, by helping to coordinate care and reduce testing duplication and prescription contraindication, which can cause further health problems.

According to researchers, 64.9 percent of seniors in the Miami area visited a primary-care doctor at least once a year from 2003 through 2007. Nationally, 77.6 percent of senior patients visited a primary-care doctor.

Experts cite a culture in the Miami area of demanding an expensive specialist for problems that could be intercepted by less expensive primary-care physicians. And while this culture exists to some extent throughout the country, it is more pronounced in the Miami area. In addition, Miami-Dade lacks an adequate supply of primary-care physicians and gerontologist in particular.

The lack of primary-care physicians, in turn, is driven by the decision of the majority of medical students to pursue a medical specialty in order to earn the higher salaries that such specialties command.