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Physician Wait Times Vary Sharply Among Major US Markets

 |  By John Commins  
   January 31, 2014

Physician appointment wait times tracked in a Merritt Hawkins survey varied from one day to more than eight months. The average wait in all metro areas and specialties is 19 days. Boston has the longest waits (45 days); Dallas had the shortest (10).

A survey on wait times for physician office visits [PDF] in 15 cities across the nation could be a harbinger for access to healthcare providers under the Patient Protection and Affordable Care Act.

First the bad news: Even before Obamacare's expanded coverage really kicks in, patients hoping to schedule an appointment with a physician in 2014 should expect to wait for several weeks in most parts of the country. Those on Medicaid, stand about a 50–50 chance of being seen by a doctor.

Now the good news: The wait time for an office appointment in 2014 is 18.5 days in five specialty areas—cardiology, dermatology, obstetrics/gynecology, orthopedic surgery and family practice—an 11% decrease from 2004 when the average wait was 20.5 days.

What's not clear, however, is if this trend will continue as an estimated 16 million people gain health insurance coverage under Obamacare.

All of this data comes from Irving, TX-based physician recruiters Merritt Hawkins, which every five years conducts a survey of nearly 1,400 physicians' offices in 15 large cities to get an idea of the wait times for office visits.

Once again, Boston, the Hub of Romney care, has the longest average wait times for doctor appointments of the 15 metro markets examined in the survey:

  • 72 days to see a dermatologist
  • 66 days to see a family physician
  • 46 days to see an OB/GYN/
  • 27 days to see a cardiologist
  • 16 days to see an orthopedic surgeon

On average, it takes more than 45 days to schedule a doctor appointment in the Boston area.

Merritt Hawkins has conducted the survey in 2004, 2009, and 2014 and each time Boston has averaged the longest wait times among the 15 cities surveyed.

Kurt Mosley, vice president of Strategic Alliances at Merritt Hawkins says it's not surprising that Boston has the highest wait times because 97% of Massachusetts residents are insured. And while Massachusetts has about 508 physicians per 100,000 people [PDF], one of the highest ratios in the nation, many of those physicians are in academia and aren't seeing patients regularly.

On the other end of the spectrum sits Dallas with the shortest wait times for physician office appointments: 10.2 days for specialists and five days for family physicians. Texas has 264 physicians per 100,000 people, the lowest ratios in the United States, which overall averages 373 physicians per 100,000 people.

Not coincidentally, Boston has the highest rate of Medicaid acceptance tracked in the survey at 73%, while Dallas has the lowest at 23%. One in three people in Texas have no health insurance, the highest percentage of uninsured residents in the nation. Texas has vehemently rejected Medicaid expansion money offered by the federal government under Obamacare.

"Texas is still a fee-for-service bastion. We never really caught on with managed care," Mosley says. "The doctors see patients with insurance and Medicaid acceptance is low. And they when you look to see how many doctors per state it's odd because we don't have many doctors per state here in Texas, but they do see people."

Mosley says a lot of the demand for physician services has been taken up by advance practice nurses. "That is a real growth area in Texas. The scope of practice has expanded a lot in the state," he says.
Overall, the average rate of Medicaid acceptance for all five specialties in all 15 markets is 45.7%, the survey shows.

Other average physician appointment wait times tracked by the survey include 28 days to see a cardiologist in Denver, 49 days to see a dermatologist in Philadelphia, 35 days to see an OB/GYN in Portland, OR, 18 days to see an orthopedic surgeon in San Diego, and 26 days to see a family physician in New York.

Physician appointment wait times tracked in the survey varied from as little as one day to over eight months, with an overall average in all metro areas and all specialties of about 19 days, the survey showed.

Mosley says the shorter waiting times seen in 2014 have a lot to do with the economy and the shift toward high-deductible health plans.

"We have lingering high employment, which means fewer insured people, many of whom are deferring seeing a doctor. And another area is a cultural shift as high deductable plans and high co-pays change people's mindsets. A lot of people no longer reflexively see the doctor when they have a problem now that they have more skin in the game. They think twice about it," he says.

"Nevertheless, even in cities with a large number of doctors per capita you are going to wait a few weeks before you see a doctor. In what other service arena does that happen? Last time I saw a lawyer she was open that day."

Mosley says the trend of shorter waiting times is about to be reversed as the growing numbers of people with health insurance collide with a rapidly aging physician demographic.

"(The Department of Health and Human Services) said that over the next seven years they estimate 250,000 doctors will retire. And we already know that the number of doctors over age 55 is 41%. So, then the wait times will dramatically go up," he says. "We see the storm coming and we need to be prepared for it."

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John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.

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