The majority of physicians in the U.S. are now salaried and working for large health systems (see: For the first time ever, less than half of physicians are independent). Also, wait times for an appointment with a family physician or primary care physician (PCP) are increasing (see: PCP wait times are 50% higher than 2014). This can be the source of great frustration for patients (see: Report: 20% of patients have changed doctors because of long wait times). These two facts may or may not be related. Here is an excerpt from the article on physician wait times:
The average patient waits 29.3 days to see a family medicine physician in large cities, according to a recent survey....This wait has increased 50 percent since 2014, according to the report....Of the 15 major metropolitan areas studied, average wait times for family medicine physicians exceed 14 days in 12 markets. Patients wait the longest to see a family medicine physician in Boston, clocking in 109 days on average. The shortest wait times are in Minneapolis, where patients wait an average of eight days to see a primary care physician, according to the report. Patient wait times have increased most for PCPs, though they are longest still for dermatologists.
There are a number of possible reasons why appointment wait times are increasing for family physicians and PCPs nationally. For example, there may be fewer physicians functioning as PCPs (see: Can the dwindling numbers of primary care physicians explain decreased life expectancy?). PCPs may be spending an increased amount of time with each patient, attributable perhaps to the burden placed on them by the inefficiency of EHRs (see: 61% of Physicians Say EHR Systems Reduce Clinical Efficiency). Physician practices and appointments may not be managed optimally. Large health systems may be decreasing the number of PCPs in hospitals within a market because of the slim profit margins for their efforts (see: The "Proximity Advantage" Enjoyed by Retail, Walk-In Clinics Over Health Systems; Actions by Amazon May Be a Preview of Expansion into Primary Healthcare). PCPs don't perform procedures (e.g., surgical procedures, colonoscopies) that are more generously remunerated than office visits by payers.
Obviously, long wait time to schedule a visit with a PCP can be frustrating for patients. However, does this necessarily mean that health problems are going unattended? I am sure that this is often the case but, increasingly, healthcare options are available other than physician office visits. One example is CVS/MinuteClinics which are growing rapidly (1,100 MinuteClinics inside CVS Pharmacy and Target stores). Walmart Care Clinics, of which there are about 2,000, is another example (see: 7 statistics on urgent care centers, EDs & retail clinics). There are also about 7,100 urgent care clinics in the U.S. (see: 7 statistics on urgent care centers, EDs & retail clinics). To restate the obvious, the long wait times to see a family practitioner or PCP may be driving patients toward urgent care clinics and walk-in clinics for which no appointment is required.
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