Doctor Wait Times Soar 30% In Major U.S. Cities

Patients are waiting an average of 24 days to schedule an appointment with a doctor, according to a study of commonly used specialty physicians in 15 major U.S. cities.

The time to schedule an appointment has jumped 30% in 15 U.S. metropolitan areas from 18.5 days in 2014 amid a national doctor shortage fueled by aging baby boomers, population growth and millions of Americans with health insurance. The survey by MerrittHawkins, a unit of healthcare staffing firm AMN Healthcare, polled more than 1,400 physicians looking at average wait times among five specialties: family medicine, dermatology, obstetrics/gynecology, orthopedic surgery and cardiology.

The analysis comes as the Republican-led Congress pushes ahead with plans to replace the Affordable Care Act with the American Health Care Act, also known as Trumpcare. The Congressional Budget Office last week said the AHCA–developed by Speaker Paul Ryan and lieutenants in the U.S. House and endorsed by Donald Trump–would cause 24 million Americans to join the ranks of the uninsured by 2026. A House vote is scheduled for this week.

The longest wait to see a doctor was in Boston, where the average wait was 52 days to schedule an appointment with a family physician, dermatologist, cardiologist, orthopedic surgeon or obstetrician/gynecologist.

“Growing physician appointment wait times are significant indicator that the nation is experiencing a shortage of physicians,” said Mark Smith, president of MerrittHawkins.

Because the ACA expanded coverage and is one reason doctor wait times are up, it’s unclear whether reducing health benefits would have the opposite impact. A physician shortage existed long before the ACA was signed into law by President Barack Obama. Analysts don’t expect that to improve until more federal dollars flow to expand residency programs that are funded by Medicare, which capped spending on doctors-in-training more than 20 years ago under the 1997 Balanced Budget Act.

The Association of American Medical Colleges last week came out with its latest report, projecting a shortage of between 40,800 and 104,900 doctors by 2030. At that time, the AAMC said there will be a shortage of between 7,300 and 43,100 primary care doctors.

The AAMC report indicated an aging population is fueling the need for more doctors.

“As our patient population continues to grow and age, we must begin to train more doctors if we wish to meet the healthcare needs of all Americans,” AAMC president and chief executive Dr. Darrell Kirch said. “By 2030, the U.S. population of Americans aged 65 and older will grow by 55%, which makes the projected shortage especially troubling. As patients get older, they need two to three times as many services, mostly in specialty care, which is where the shortages are particularly severe.”

Insurers are pushing more of a team-based approach to healthcare to keep a lid on healthcare costs as the population ages, with the federal government shifting more Medicare dollars away from fee-for-service payment to value-based care models.

But most of the new models use a physician as a quarterback even as doctors are handing off more responsibilities to physician assistants and nurse practitioners.

Medicare and most private insurers, including Aetna , Anthem , Cigna and UnitedHealth Group , are moving to alternate payment models, which emphasize primary care professionals. But for these to work, patients still have to get in to see a primary care physician, and the waits are long. In the Boston area, it takes 109 days just to see a family physician, the Merritt analysis showed.

“Finding a physician who can see you today, or three weeks from today, can be a challenge, even in large urban areas where there is a relatively robust supply of doctors,” MerrittHawkins’ Smith said. “The challenge becomes even more difficult in smaller communities that have fewer physicians per population.”