U.S. patients wait 18.5 days, on average, to see a doctor when they make an appointment with a new physician practice, according to a survey by Merritt Hawkins conducted before the rollout of the Affordable Care Act's (ACA) coverage expansion.

(See the Advisory Board's take on this survey.)

For the survey, the health care consulting firm surveyed 1,399 physician practices in 15 metropolitan areas across the nation between June and November of last year. Merritt Hawkins researchers surveyed the practices by calling and asking for the first available appointment for a new patient needing routine care, such as a "well-woman visit" or heart check-up. Researchers called practices in five specialties: primary care, cardiology, dermatology, orthopedic surgery, and obstetrics-gynecology.

The survey found that patients waited 18.5 days, on average, to see a physician in any of the five specialties in the 15 cities. 

The longest wait was for primary care physicians (PCPs) in Boston, where patients waited an average of 66 days to see a PCP. Meanwhile, patients in Dallas looking for a new PCP had the shortest average wait, at just five days. 

"We have too few providers, which is creating a significant access problem," Merritt Hawkins SVP Travis Singleton told Kaiser Health News' "Capsules."

Shortage ahead: Which doctors will be in highest demand?

The average wait time has decreased since the firm last conducted the survey in 2009, at which point patients waited an average of 20.4 days for a new doctor. However, fewer physicians were accepting Medicaid in 2013 than they were in 2009, according to the survey.

About 45.7% of physicians said they would accept Medicaid in 2013, down from 55.4% in 2009. Acceptance of Medicaid in the latest survey varied from 73% in Boston to 23% in Dallas. Meanwhile, about 76% of physicians said they accepted Medicare.

"At the end of the day, it doesn't matter how many physicians you have…If no one will take your insurance, you're going to end [up] in the same place, and that's probably the ED," Singleton said, adding that the problem may worsen with the expansion of Medicaid under the ACA.

Ken Hertz, a consultant at MGMA Health Care Consulting Group, countered that wait times do not necessarily increase in proportion to patient volume. Patient volumes in outpatient settings have declined in recent years as plan deductibles and copays have increased, he added.

"Most practices are working diligently to see patients and see them in a timely manner, but there are a lot of moving parts," he told KHN. He added that the "successful practices will figure out new ways and approaches to shortening wait times" (Gold, "Capsules," KHN, 1/29).

The Advisory Board's take

Ayal Bitton, SOUTHWIND

We’ve long known that wait times to get a physician appointment are unacceptable by patients’ standards.

However, this Merritt Hawkins data sheds new light on an old issue. Here's what I'd call out for readers.

• Improvement efforts to date are insufficient. Regardless of the debate around physician shortages or insurance acceptance, the reality is that physician appointment wait times can be significantly reduced. While the Merritt Hawkins’ 2014 Survey reveals that some specialties in some markets have achieved the improvement needed, the majority of providers are struggling to find their right formula to improve this level of access. (Hint…it’s not just about scheduling and phone management.)
• Family practice still has a long way to go. As the lynchpin to population health, family practice needs to be able to cater to younger generations of families and well patients. These patients respond to convenience and will not accept a 20-day wait period. Instead, they will seek out and utilize other options available to them—competitors, pharmacies, or no care at all.

Making strides to improve physician appointment wait times starts with a fundamental realization—patients choose where they go for care and they prioritize where they go based upon service quality and easy access. According to the Altarum Institute Survey of Consumer Health Care Opinions, 88% of patients cite “easy to get an appointment” as “very important.

But one of the common mistakes we see health care providers make is to narrowly define the access improvement effort. Many providers look only at scheduling, call centers, and front-end processes. However, appointment wait times are just a part of the larger patient access equation.

So which strategies ultimately succeed? The ones that are much more expansive, focusing as much on cultural transformation as operational improvements, and thereby much more effective at improving access points across the entire continuum of care.

If your average wait time does not exceed the results in the Merritt Hawkins survey, we can help. Contact me to learn more about our approach to improving patient access.