by Emily Michels, Health Policy Fellow

Long wait times for doctor’s appointments could have a much bigger impact on your life than the annoyance of being stuck listening to office hold music.

In a 2001 report, The Institute of Medicine’s (IOM) Committee on Optimizing Scheduling in Health Care ranked timeliness of appointments on the same level of importance as safe, effective, and efficient treatment in terms of fundamentals of healthcare. Now, in their 2015 report, they’ve examined the fact that the inability to schedule a timely appointment is still an ongoing barrier to healthcare. According to the 2013 Colorado Health Access Survey (CHAS), 15 percent of Coloradans were unable to schedule an appointment as soon as they thought it was necessary.

And while there is variability across states and medical specialties, multiple studies across America identified average wait times for appointments to be longer than 30 days, and up to 122 days in some facilities. The type of insurance you have could also affect your wait – not all providers accept Medicaid making those appointments more competitive, and studies have shown that children with Medicaid or CHP+ are more likely to wait over a month for an appointment than those with private insurance. And since patients with mental health concerns or substance abuse issues may need to schedule an initial appointment with a primary care provider before reaching a secondary provider, these consumers face going through a long wait period twice.

Below are some of the reported effects of timing on consumers:

Long Wait Times

Timely Appointments

  • Give up on seeking treatment altogether
  • Using retail clinics instead of their normal facilities
  • Negative effect on morbidity, mortality, and quality of life
    • Connection to cancer, joint troubles, spinal fractures, and cataracts
  • Financial burden (if the patient has to seek out-of-network treatment)
  • Negative perception of treatment received
  • Higher chance of missed appointments
  • Non-urgent matters going to emergency treatment centers
  • Comfort and trust for healthcare providers
  • Reduced morbidity and mortality of certain afflictions
    • Reduced effects of kidney disease, addiction, and mental health issues
  • Spend less time being sick/getting sicker
  • Positive perception of treatment received
  • Likely to continue seeking treatment
  • Emergency clinics not slowed down by patients with non-urgent issues

While lack of timely appointments may seem to stem from a lack of resources, the IOM believes the system can be improved through a change in approach. Overly complicated scheduling programs cause confusion for consumers and clerks. The insistence on in-person visits for patients that may not need them also clogs the system unnecessarily. Various health systems report that approximately one-quarter of the consumers calling in daily could be treated through telemedicine or other out-of-office technologies.

Just as effective treatment and adequate networks are important factors of healthcare access, so too is scheduling an appointment with a provider. In order to improve the consumer experience, we need to identify ways in which long wait times and their consequences can be corrected and prioritized.

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