According to a survey conducted by healthcare consulting firm Merritt Hawkins , patients in major metropolitan areas can expect to wait an average of 18.5 days to see a doctor. In some areas and specialties, things were far worse than the study’s national average. For instance, in Boston, wait times for specialists in cardiology, dermatology, orthopedic surgery and obstetrics / gynecology averaged over 45 days; for a family practitioner, Bostonians can expect to wait more than 2 months (or 66 days) for an appointment. To make matters worse, the study was conducted this summer – before the Affordable Care Act’s coverage expansion took effect.
Kyruus performed a similar exercise to assess not only wait times, but also the ease of scheduling appointments, and the overall patient experience in the appointment booking process. By utilizing “mystery shopper” calls, we reached out to 40 major hospitals and health systems across Cleveland, Chicago, Philadelphia and New York / New Jersey to attempt to book routine appointments in dermatology, orthopedics and cardiology. To best approximate the experience of a brand new patient, we used a given hospital’s “Patient Scheduling” phone number listed on the hospital’s website or, when there was not one provided, the hospital’s main contact line.
Across all markets and specialties, we experienced an average of a 31-day wait time, 68% longer than the averages found in the Merritt Hawkins study. Dermatology was the toughest appointment to book, across all markets, with an average wait time of 43 days. Orthopedic surgery was the easiest, averaging 21 days.
New York had the longest wait times across the 3 specialties with an average of nearly 65 days while Chicago fared the best, averaging just under 25 days.
Beyond increasing patient annoyance and decreasing overall patient satisfaction, long wait times like these can also result in severe financial strains on our healthcare system. A study from NEHI and the National Quality Forum suggests that a “lack of timely appointments drives patients to the ED.” With the average cost of a visit at around $580 per visit, unnecessary use of the ED costs our system $38 billion.
Perhaps more troubling than these long appointment wait times, however, was the ability – or, more accurately, inability – to book an appointment at all. Only 18 of the 40 hospital calls we made for dermatology resulted in a booked appointment – 12 of the 40 for both cardiology and orthopedic surgery. In other words, we successfully booked an appointment a paltry 35% of the time. The remaining 65% of the time, we were either:
- Placed on hold for a lengthy period of time (over 15 minutes) and hung up;
- Told to call back later;
- Informed that the person to whom we were speaking did not have the ability to view physicians’ schedules; or
- Routed through numerous departmental transfers that eventually dead-ended.
Even when we were properly serviced, there were numerous calls in which the call center agent spent several minutes looking for the right physician to send us. These large swaths of time – seemingly wasted by navigating antiquated information and decision support tools – could have been spent servicing the calls of real patients trying to access care.
Results like these, and those that Merritt Hawkins generated, highlight multiple aspects of the very real problems with patient access that plague our system today. On one hand, Merritt Hawkins’ study underscores the strains that we are feeling on a macroscopic level: demand for care has already exceeded our capacity to serve it and things look only to get worse.
On the other hand, our own anecdotal / experiential results highlight a major issue at the operational level – that healthcare organizations are woefully unable to properly serve patients who are trying to access providers using current technologies and information tools. For example, we have found, in our conversations with call center agents, that there is little to no ability to view across schedules to see which providers on staff is available soonest; as a result, we were placed on lengthy holds while they dove into provider calendars one at a time.
In a world where a patient’s overall care experience is disproportionately affected by their first point of contact with a system, hospitals and health care systems should be armed with accurate information and decision support tools to serve patient populations effectively. Call center agents, patient access coordinators, front-office staff and physicians need better ways to leverage information about their providers and colleagues so that patients can benefit from their talents.
Request a demo today to find out how Kyruus’ ProviderMatch optimizes Patient Access, Referral Management, and Care Coordination through more precise patient-provider matching.
 Reducing Emergency Department Overuse: A $38 Billion Opportunity (2010), NEHI and NQF, available at: http://www.qualityforum.org/NPP/docs/Reducing_ED_Overuse_CAB.aspx.