Elective Healthcare and Discretionary Spending
Providers must go beyond clinical expertise to compete with a weekend vacation.
This article is a little different.
Leaving Healthcare is about why providers are reducing or eliminating clinical work, and what they do next in their professional careers. But in this post, I’m going to address the patients that choose to leave healthcare.
The inflation economy has exposed just how vulnerable elective healthcare can be. Patients will address the most essential care during these times, but, as we’ll see, our definition of “essential” can be very different from theirs.
Do I really have to tell you why Americans are spending less?
This is the part of the article where I would normally present some mouth-watering data delicately wrapped in insights and just a dash of opinion. But I think I can spare you an exhaustive read on why Americans lack confidence in their economy. An April 2025 Gallup poll summarizes the various concerns we have and how they are trending over time (source). In short, people are still very worried about the costs of living even though inflation has normalized over the past three years.
Elective care takes a hit when the economy is rough
Urgent and essential care is pretty darn recession-proof. Elective medical procedures? Not so much.
A 2025 report found that lead volume for elective surgical practices decreased by 19% last year (source). The American Dental Association (ADA) reported in Q1 of this year that the number of dentists saying they weren’t busy enough increased by 4% (source). The American Veterinary Medical Association (AMVA) noted a 2.3% decline in consumer spend last year, despite the percentage of households who own dogs and cats increasing.
Now I’d like to believe that oral health and the health of our furry friends is essential, but the American consumer is telling us otherwise.
Changing definitions of “essential” and “elective”
Let me start by stating that I think we need more data on this topic. The AMA, ADA, AMVA, and other professional associations monitor patient spending in the macro, but I have not seen more detailed analysis on specific types of services. I think our own professions would disagree on classifying which of their services are essential and which are not.
In my opinion, there are three types of healthcare services:
Essential - treating active disease or adverse condition
Preventative - reducing risk for disease or adverse conditions
Elective - no disease or adverse conditions present
Using dentistry as an example:
Essential - a filling to treat tooth decay
Preventative - orthodontic appliances to prevent a mild malocclusion from getting worse
Elective - veneers
It is intuitive that, during difficult economic times, spending on preventative and elective procedures decreases. My hypothesis is that, during such times, patients also change their definition of what is essential.
Tooth decay is not an immediate threat to life and neither is hypertension. Patients take action to treat these diseases either because they understand that they will get worse or because they have waited too long and they are suffering from more urgent symptoms. I believe that even the more proactive patients will defer essential treatment in an uncertain economy. They reconsider their definition of what is truly essential.
So what can healthcare providers do about it?
What emerges across all sectors is the growing importance of perceived value. In an inflation-sensitive world, patients (or their caregivers) are asking: “Is this worth it?” To answer that, healthcare providers must articulate more than just the clinical benefits of care. We also need to address convenience, affordability, and customer experience.
If a patient is deciding between paying their rent or getting a filling done, then I certainly understand their decision to choose the former. This is a case of someone who is under genuine financial distress.
But for many more folks the situation is less dire. They have some additional money after they’ve paid for their costs of living (and hopefully contributed to their savings). And those discretionary extra dollars can and should be spent on fun things. But they should also be spent on their healthcare needs even if they are not their healthcare wants. Our job is to close the gap between need and want by making our services more convenient, affordable, and improve their experience receiving them.
The future of elective healthcare will belong to those who can balance financial realities with patient needs. Whether you're a dermatologist, dentist, or veterinarian, the question isn’t just “Can patients afford this care?” It’s “Have we given them enough reason to prioritize it?”