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ECG Management Consultants Survey Determines US Patients Wait an Average of 38 Days for Care

Patients outside the US wait even longer to see healthcare specialists with some appointments scheduled a year out in the Canadian province of Nova Scotia

Data recently released by healthcare consulting firm ECG Management Consultants (ECG) reveals that patients in the United States wait an average of 38 days for healthcare appointments. That figure is a significant stretch from the desired industry standard of 14-day or less wait times, according to Becker’s Hospital Review.

Clinical laboratories serve the needs of physicians who see patients and refer testing needed by patients to labs. Thus, average wait times should be of interest to lab professionals who strive to meet reporting turnaround times for lab test results, particularly given the unique way that ECG conducted its survey of patient wait times.

In “The Waiting Game: New-Patient Appointment Access for US Physicians,” ECG wrote, “Adopting a ‘secret shopper’ approach, we put ourselves in the shoes of the average patient trying to book an appointment. We contacted nearly 4,000 physician practices in 23 major cities across the US, posing as a new, commercially insured patient seeking care for general, nonemergent conditions that typically don’t require a physician referral.”

ECG’s study provides “a realistic view of where and in what specialties patients face the most significant challenges to accessing routine care,” the authors wrote in their published report. The report also includes patients’ appointment-keeping behavior based on length of wait times. 

“Consumer expectations have evolved significantly in all industries. From buying a plane ticket to making a restaurant reservation, the consumer experience has been highly optimized and customers in turn have become accustomed to information and services being available at their fingertips. They bring the same expectations about speed and convenience to healthcare,” the researchers explained.

ECG pointed out that when patients are required to wait 14 days or more to see their physicians, no shows and cancellations increase dramatically.

“Numerous studies have shown that patients are significantly less likely to show up for appointments that are scheduled further out,” the study authors noted.

“One of the takeaways was how difficult the patient experience is. Not only did our secret shoppers have to go out and find physicians, they had to sit on the phone sometimes on very long holds and go through multiple barriers and jump through hoops,” Jennifer Moody (above), partner with ECG Management Consultants and one of the authors of the study, told Becker’s Hospital Review. “Even in that case, they weren’t successful in scheduling appointments with all the practices they called. I think of the average consumer who might be having a similar experience,” she added. Lengthy wait times are not believed to be an issue when patients need clinical laboratory tests. (Photo copyright: ECG Management Consultants.)

Getting Authentic Results

To gather the study data, ECG distributed its secret shoppers throughout 23 major US cities, reaching almost 4,000 physician practices (between 145-168 per city) to schedule appointments for non-emergency conditions not needing a physical referral.

The researchers gathered wait times for TNAAs (third next available appointments), a common metric. They chose TNAAs because first and second appointments often produce unclear results due to extenuating circumstances or late cancellations, Becker’s Hospital Review reported.

The researchers recorded TNAAs for the following specialties:

  • Cardiology (39 days),
  • Dermatology (40 days),
  • Family medicine (29 days),
  • Gastroenterology (48 days),
  • General surgery (22 days),
  • Neurology (63 days),
  • Obstetrics/gynecology (37 days),
  • Ophthalmology (37 days),
  • Orthopedic surgery (20 days),
  • Pediatrics (24 days), and,
  • Rheumatology (68 days).

They found the average wait time to be 38 days. And “of the 253 metropolitan market and specialty combinations included in this research, only 6% had an average wait time of 14 days or less,” Becker’s reported.

The researchers omitted the physician practices that were unable to either take or return calls, take messages, or provide a hold time under five minutes to give the secret shopper an answer, Becker’s added.

Jennifer Moody, Partner, ECG Management Consultants, one of the authors of the study, “was particularly surprised by the portion of callers who never even made it to the stage of learning about wait times. Out of 3,712 physician practices, callers were able to secure responses from only 3,079, meaning nearly one in five physician practices could not provide appointment availability information,” Becker’s reported.

The lowest average wait time in all specialties was 27 days in Houston, and the longest was 70 days in Boston. “A key takeaway from the report is that physician concentration does not guarantee timely access, as a major healthcare hub like Boston helps illustrate,” Becker’s noted, adding that physicians in such areas may “devote time to teaching or research over appointments.”

The graphic above, taken from ECG’s published report, shows the average TNAA times recorded by their secret shoppers at medical specialty practices in major cities across the US. (Graphic copyright: ECG Management Consultants.)

Other Country’s Wait Times

Healthcare systems outside the US struggle with patient wait times as well. Forbes reported that patients of Canada’s public health system “faced a median wait of 27.7 weeks for medically necessary treatment from a specialist after being referred by a general practitioner. That’s over six months—the longest ever recorded.”

Patients in Nova Scotia wait even longer. There they “face a median wait of 56.7 weeks—more than a year—for specialist treatment following referral by a general practitioner. Those on Prince Edward Island are also in the year-long waiting club—a median of just over 55 weeks,” Forbes noted.

And in the UK, a recent survey found that “more than 150,000 patients had to wait a day in A&E [accident and emergency] before getting a hospital bed last year, according to new data,” with the majority of those patients over the age of 65, according to The Guardian.

ECG suggestions that may reduce wait times include:

  • Adopt automation and self-service tools in an “easily navigable platform” that enables patients to schedule appointments 24/7.
  • Ensure healthcare providers are “utilized appropriately and at the top of their license.”
  • Address inequities in access to healthcare regardless of patients’ location or socioeconomic status.

There is more in the ECG report that hospitals—as well as clinical laboratories—can use to reduce patient wait times to see care providers. As the authors wrote, “For patients, the first step of the care journey shouldn’t be the hardest.”

—Kristin Althea O’Connor

Related Information:

The 38-day Delay: What the Wait Time Average Says about Healthcare Access

The Waiting Game: New-Patient Appointment Access for US Physicians

In the US, Wait Times to See a Doctor Can Be Agonizingly Long

Canadian Health Care Leaves Patients Frozen In Line

Tenfold Rise in A&E Patients Waiting More than 24 Hours for a Bed

Private Healthcare on Rise as Britain’s Public Healthcare System Faces Horrific Conditions, Walkouts

Challenges abound as the NHS tries to recover before UK citizens move to private insurance; some patients have wait times of up to six months for a histopathology diagnosis of cancer

Britain’s National Health Service (NHS) is in dire straits. The UK’s vaunted state-run healthcare system is overrun with appallingly poor conditions, impossibly long wait times, diminished care, and multiple walk-outs in various medical fields that Dark Daily reported on last week in “British Junior Doctors Stage Four-Day Walkout Demanding Increased Pay and Better Working Conditions.”

As we noted, thousands of clinical laboratory tests and surgical pathology readings had to be delayed or cancelled due to the strikes.

An NHS worker in a Liverpool hospital told CNN that conditions felt like a “war zone” with patients being treated in the backs of ambulances, corridors, waiting rooms, cupboards, or not at all since hospitals are well over capacity.

As a result, UK residents are increasingly bypassing the long wait times for the NHS’ “free” healthcare and instead paying out of pocket for private health insurance, CNN reported in “Why is Britain’s Health Service, a Much-loved National Treasure, Falling Apart?

Chris Thomas

“Those who can afford to get private insurance are,” Chris Thomas (above), told The Guardian. Thomas is Head of the Commission on Health and Prosperity for UK progressive policy think tank the Institute for Public Policy Research (IPPR). “People are not opting out of the NHS because they have stopped believing in it as the best and fairest model of healthcare,” he said. “Rather, those who can afford it are being forced to go private … and those without the funds are left to ‘put up or shut up.’” (Photo copyright: Institute for Public Policy Research.)

Two-Tier System Could Become UK’s Norm, Dividing Classes

The drive towards private insurance is leaving Britain on the brink of having a “two-tier” system where the NHS is overpowered by private healthcare. And it’s not an unwarranted fear. One in six people in Britain are prepared to use private healthcare instead of waiting for the NHS, The Guardian reported.

A report from the Institute for Public Policy Research (IPPR) claims a UK two-tiered system would not mimic what we have here in the US. Rather, if the trend continues in the private direction, it would more likely be comparable to dentistry in England, “… where poor NHS access exists for some and superior but expensive access exists for many. We stand at the precipice of a growing ‘opt-out’ by those who can,” according to the IPPR report, The Guardian noted.

More importantly, this could further divide classes. “Such a trend could threaten the deep and widespread public support for the NHS among voters and leave millions of patients vulnerable because of their ethnicity, postcode, income or job,” The Guardian noted the IPPR report as saying.

In an op-ed she penned for CNN, titled, “We Can Barely Breathe. How Did Britain’s Treasured NHS Get So Sick?” Internal Medicine Junior Doctor for NHS in South East England, Roopa Farooki, MD, described the conditions her son witnessed when he arrived at her ER with a shoulder injury on one of her days off.

“It’s different when you see your everyday reality though naïve eyes. He saw the elderly patients on the jigsaw of trolleys crammed into the department, pushed against the wall, squeezed in the gap between the bed and nursing stations.

“He saw the fluids hanging from rails where we had no stands, lines running into the patient’s forearms. He saw the oxygen fed into their noses from cylinders propped along the bed, the cacophony of beeping machines and alarms.

“It doesn’t look like it does on the TV. It doesn’t even look like it does on reality TV,” she wrote.

The healthcare statistics are alarming. According to CNN:

  • There was a 20% increase in excess deaths the final week of December 2022, compared to the previous five years.
  • Half of patients waiting for emergency care that month waited for more than four hours, which was a record.
  • Also in December, 54,000 people waited more than 12 hours for emergency admission. The wait was “virtually zero” prior to the COVID-19 pandemic.
  • And “category 2” conditions, such as a stroke or heart attack, had a more than 90-minute wait time for ambulance attendance. The target response time is 18 minutes.

Dim Hopes for Improvement

Though the NHS has struggled in recent years, the challenges are seemingly worse now. “This time feels different. It’s never been as bad as this,” gastroenterologist Peter Neville, MD, a consultant physician who worked with the NHS since 1989, told CNN.

CNN noted that a perfect storm of challenges might have brought the NHS to where it is today. COVID-19, flu seasons paired with COVID, lack of financial support, lack of social support, staffing and morale issues are just some of the problems that the NHS must address.

Experts point out that as the NHS’ struggles increase so begins a loop where one problem feeds another. Patients who wait to be seen have treatments that take longer, then they get sicker, and the cycle continues.

Despite having one of the highest proportions of government healthcare spending on Earth, up to 40% of Britons report having accessed or plan to access private care, Breitbart reported.

Sadly, it’s unlikely enough cash will come in from the UK government to make significant improvements for the NHS. The budget announcement in November showed the NHS was to get an average 2% spending increase over the next two years, CNN reported.

Are there lessons here for US hospitals, clinical laboratories, and pathology groups? Perhaps. It’s always instructive to see how our fellow healthcare providers across the pond respond to public pressure for more access to quality care.

—Kristin Althea O’Connor

Related Information:

Why is Britain’s Health Service, a Much-Loved National Treasure, Falling Apart

Private Healthcare Boom Adds to Fears of Two-Tier System in UK

IPPR Report: The State Of Health and Care 2022

Opinion: ‘We Can Barely Breathe,’ How did Britain’s Treasured NHS Get So Sick?

Britons Flock to Private Doctors as Socialized Healthcare Fails to Deliver on Time

British Junior Doctors Stage Four-Day Walkout Demanding Increased Pay and Better Working Conditions

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