Long appointment waits may signal doctor shortage

Boston patients faced the longest waiting times for routine care, regardless of the specialty, a new survey says.

By Susan J. Landers — Posted June 1, 2009

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A survey of five medical specialties in 15 large metropolitan areas found that new patients can wait weeks for an appointment, suggesting the need for more physicians.

People in Boston experience the longest wait times, averaging 70 days to see an obstetrician-gynecologist, 63 days to see a family physician, 54 days for a dermatologist, 40 days for an orthopedic surgeon and 21 days for a cardiologist.

Philadelphia and Los Angeles scored the next highest average wait times for those five studied specialties. Houston and Washington, D.C., rounded out the top five.

Boston's position comes as no surprise, surveyors said. The demand for doctors has soared since Massachusetts implemented its health system reform plan in 2006 to provide insurance coverage to hundreds of thousands of uninsured residents.

The survey findings should set off alarms for policymakers talking about reform, said Kurt Mosley, vice president of business development at Merritt Hawkins & Associates, a physician recruiting and consulting firm in Irving, Texas, that conducted the survey. "Before we start promising care to more people, we need to have more physicians," he said.

Addressing physician shortages has been a concern for the AMA, which has long-standing policies supporting efforts to increase the number of physicians across specialties.

Survey calls were made to 1,162 medical offices throughout the country, requesting the first available new-patient appointment. Surveyors cited hypothetical, nonemergency reasons for the appointments, such as a heart check-up, a skin exam to detect possible cancers and a routine physical.

Surveyors found a wide range of responses among specialties regarding the acceptance of Medicaid. In Atlanta, for example, 100% of surveyed cardiologists accepted Medicaid while none of the dermatologists did.

In general, Medicaid was not widely accepted in most markets because of its relatively low reimbursement rates and sometimes problematic billing process, surveyors said.

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A long time coming

A new survey looked at patient wait times to get appointments for specialists in 15 metropolitan areas between September 2008 and March 2009. Surveyors also asked if a practice accepted Medicaid patients.

Here are the average wait times:

Days to appointment
Shortest Longest Average Accepting Medicaid
Cardiology 2.4 48.6 15.5 82%
Dermatology 3.4 104.4 22.1 44%
Obstetrics-gynecology 2.5 98.7 27.5 41%
Orthopedic surgery 2.9 59.9 16.8 44%
Family practice 2.5 99.6 20.3 65%

Source: "2009 Survey of Physician Appointment Wait Times," Merritt Hawkins & Associates, May 5 (link)

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