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Waiting for a doctor's appointment in Miami is getting longer these days
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According to Merritt Hawkins and Associates, a consulting firm that specializes in recruiting physicians and other health care professionals, the time between calling a doctor’s office and actually getting the appointment has gotten longer in Miami just as it has in all of the 15 cities surveyed.
The 2009 Survey of Physician Appointment Wait Times is an attempt to focus on the physician supply discussion by tracking the time it takes patients to schedule physician appointments.
Like the last survey done by Merritt Hawkins in 2004, this one measured average appointment wait times in family practices as well as four specialties: cardiology, dermatology, obstetrics/gynecology and orthopedic surgery and included 1162 medical offices.
On average, wait times were found to have increased by 8.6 days per city. Boston had the longest wait, averaging 49.6 days, followed by Philadelphia with 27 and Los Angeles with 24.2. In Miami the average wait is 14.4 days. The shortest was Atlanta with an 11.2-day wait. In all cities among all the specialties, the wait was 20.5 days.
Officials at Merritt Hawkins note that it may be difficult to gauge a doctor’s availability through one phone call made to his or her office regarding the next available appointment time. Appointment times can open up unexpectedly, allowing a patient to schedule an appointment earlier than he or she might ordinarily be able to. Should a physician happen to be on vacation or otherwise away from the office, it could take a patient longer to schedule an appointment than ordinarily would be the case. In addition, demand for medical services can fluctuate in various markets during flu season, vacation season and other times when physician utilization is uncharacteristically high or low and appointment wait times could be uncharacteristically long or short during these periods.
There also are the vagaries of medical practice phone systems to consider. In some cases, researchers were not able to break through the various automated telephone sequences needed to reach a person able to schedule an appointment. In other cases, they encountered answering machines indicating the office was temporarily not taking phone calls. In those cases, researchers moved on to other medical offices. In this regard, researchers duplicated the experience of a patient new to a community “dialing through” various medical offices in search of an appointment.
Merritt Hawkins researchers called seeking appointments for non- emergent medical conditions such as exams (though in the case of orthopedic surgery, researchers called seeking appointments for injury or pain to the knee). The survey therefore does not measure physician availability in cases of medical emergency.
The researchers attempted to reach a minimum of 10 medical offices per medical specialty, per metropolitan market, with an optimum target of 20 offices. In some cases, researchers were not able to contact the minimum of 10, either because they could not reach 10 medical offices in the time allotted for the survey or because they could not find 10 medical offices in a given specialty to contact. In some areas, physicians in certain specialties have consolidated into large groups and there are few such groups from which to select.
Despite these caveats, the survey reflects in general what patients would encounter at a given time when attempting to schedule physician appointments. It is one indicator of physician availability in five medical specialties in metropolitan areas with a high concentration of physicians relative to many other areas of the country.
Phil Miller, vice president of public relations for Merritt Hawkins and Associates, has stated that the significant decrease in the number of doctors graduating medical school who choose to become family physicians or internists (primary care) is one of the biggest problems contributing to long wait times.
Not surprisingly, medical students, who often have more than $100,000 in debt, respond to market forces, choosing specialties that pay more. Just over 42% of the family medicine residency slots in this year’s match went to seniors receiving their M.D.s from U.S. med schools. About 49% of the slots went to a combination of foreign med school grads, seniors at osteopathic med schools and people who graduated from U.S. med schools in previous years. Nine percent of the slots went unfilled. In contrast, anesthesiology, which offers regular working hours and median salaries at three to four times that of a family physician filled 84% of their first year residency positions with American trained MDs. Only 1% went unfilled.
In a NY Times article, lawmakers from both parties as well as officials in the Obama administration have stated that the shortage of health care professionals is already having serious consequences. “We don’t have enough doctors in primary care or in any specialty,” said Representative Shelley Berkley, Democrat of Nevada. Senator Orrin Hatch, Republican of Utah, said, “The work force shortage is reaching crisis proportions.”
Even people with insurance have problems finding doctors. In the same article, Miriam Harmatz, a lawyer in Miami, stated that her longtime primary care doctor left the practice of medicine five years ago because she could not make ends meet. "The same thing happened a year later," Harmatz said. "Since then, many of the doctors I tried to see would not take my insurance because the payments were so low.”
“Primary care physicians are grossly underpaid compared with many specialists,” said Senator Max Baucus, a Montana Democrat, who vowed to increase primary care payments as part of legislation to overhaul the health care system.
Read the full 2009 Survey of Physician Appointment Wait Times report
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