The average wait time for the third next available appointment across 11 medical specialties in 23 U.S. metro areas is 38 days, starkly contrasting with the traditional 14-day benchmark.
The finding comes from ECG Management Consultants, which investigated patient wait times due to their difficulty in measurement and tracking. While many people have anecdotal evidence that accessing medical care is becoming increasingly slow and time-consuming, the report, "The Waiting Game: New-Patient Appointment Access for US Physicians," provides concrete data and reveals sobering average wait times across the nation.
The metrics are not intended as new benchmarks but rather provide a realistic snapshot of what patients experience when seeking medical appointments. Of the 253 metropolitan market and specialty combinations included in this research, only 6% had an average wait time of 14 days or less, which has long been the industry rule of thumb.
ECG developed a methodology for the report where secret shoppers contacted 145 to 168 medical practices in each metro area to request wait times for the third next available non-urgent appointment. This metric is commonly used to gauge patient access, since the number of days to the first or second available appointment may be artificially short due to a late cancellation or anomalous event.
The situations presented by the commercially insured secret shoppers involved conditions or needs that typically do not require a physician referral. These scenarios included appointments to establish care with primary care physicians, a stomach ulcer for a gastroenterologist appointment, a full-body skin check for dermatology, and femoral hernia irritation for general surgery.
Jennifer Moody, partner with ECG, was particularly surprised by the portion of callers who never even made it to the stage of learning about wait times. Out of 3,712 physician practices, callers were able to secure responses from only 3,079, meaning nearly 1 in 5 physician practices could not provide appointment availability information.
In the case of those dead ends, practices either directed callers to leave a message but did not return the call; placed callers on hold for over five minutes; or did not answer the call, did not offer the ability to leave a message, or were no longer open.
"One of the takeaways was how difficult the patient experience is. Not only did our secret shoppers have to go out and find physicians, they had to sit on the phone sometimes on very long holds, and go through multiple barriers and jump through hoops," Ms. Moody said. "Even in that case, they weren't successful in scheduling appointments with all the practices they called. I think of the average consumer who might be having a similar experience."
Average wait times across all specialties varied by area, ranging from 27 days in Houston, 39 days in Chicago and Denver, 44 days in Seattle, and 70 days in Boston. A key takeaway from the report is that physician concentration does not guarantee timely access, as a major healthcare hub like Boston helps illustrate.
Despite having one of the highest physician densities in the country at 577 per 100,000 population (compared to 326 per 100,000 nationally), many physicians in the area focus solely on research and teaching due to the presence of large academic medical centers. Consequently, Boston had the longest individual specialty wait times in 6 of the 11 specialties researched.
"Boston's really great for specialized medicine, but this study focused on more general medicine," said Steve McMillen, principal with ECG. "So maybe there aren't as many generalists in Boston as we would think."
MSAs with shortest average wait times
1. 27 days: Houston
2. 28 days: New York and Miami
3. 31 days: Phoenix
4. 32 days: Dallas
5. 33 days: Tampa
MSAs with longest average wait times
1. 70 days: Boston
2. 47 days: Cincinnati
3. 46 days: Charlotte
4. 45 days: Atlanta and Minneapolis
5. 44 days: Seattle
It's also important to note that if heavily populated MSAs face access challenges, smaller cities and rural areas are likely experiencing even more severe access issues. Similarly, if these are the wait times commercially insured patients are encountering, the times are likely even longer for patients seeking appointments with Medicare or Medicaid or those who are uninsured.
Mr. McMillen also highlighted what he considered surprising wait times for surgical specialties, which ranged from 20 days for orthopedic surgery — the shortest wait time among the 11 specialties measured — to 22 days for general surgery.
"From an access perspective, we try to get surgical patients seen within one week, ideally within 2 to 3 business days. The expectation is to get them in soon, so to see those wait times a few weeks out was surprising," Mr. McMillen said.
With an average wait time of over 68 days, rheumatology had the longest wait times among the 11 specialties reviewed, reflecting the workforce shortage identified in the field a decade ago. Neurology had the second longest wait time at 63 days, followed by gastroenterology at 48 days. In primary care, the average wait times for pediatrics and family medicine appointments to establish care were 24 days and 29 days, respectively.
Not only are patient wait times difficult for health systems to track, but the data can also reside in various departments of a health system: finance, operations, patient experience and, increasingly, health equity. More and more health systems have health equity officers at the table when it comes to examination of and improvement efforts for patient access.
Ms. Moody advises health systems to ensure this data is not limited to a single role among senior leadership. "This has to be something that everyone in the C-suite and everyone at the administrative executive table takes a look at on a regular basis," she emphasized.
You can find the complete report, including wait times by specialty and MSA, in "The Waiting Game: New-Patient Appointment Access for US Physicians," available here.