Americans are making fewer visits to the doctor's office and most people consider themselves healthy, according to a new report from the United States Census Bureau. Locally, the numbers are little harder to capture. Rapid City Medical Center chief executive Darrel Riddle said patient visit numbers at the center were down slightly in the past two years, mainly due to their choices in health insurance plans. Riddle said more businesses offer health savings accounts, accounts that go untaxed and can be used for medical costs. Employees often choose high deductable insurance plans and use the tax-exempt account to cover smaller health care costs. Riddle said studies have shown that employees who opt for such plans save money because people tend to have fewer doctor visits.