The 2001 IOM report, Crossing the Quality Chasm: A New Health System for the 21st Century, identified six fundamental aims for healthcare — that it be safe, effective, patient-centered, efficient, equitable, and timely. Of these, “timeliness is in some ways the least well studied and understood,” the IOM says.
The new report, Transforming Health Care Scheduling and Access: Getting to Now, aims to answer two questions: How can timely care be ensured in various healthcare settings, and what are some of the reasons that care is sometimes not timely?
While the “fast- track” report was prompted by months-long wait times uncovered recently at Veterans Affairs (VA) hospitals and commissioned by the VA, it focuses more broadly on the experiences and opportunities for improvement in the wider healthcare system.
The 137-page report finds wide variation across the country in provision of timely care and notes that long wait times to see a health provider have “multiple consequences” including negative effects on health outcomes, patient satisfaction, healthcare utilization, and the reputation of a healthcare organization.
Factors responsible for long wait times included mismatched supply and demand, the current provider-focused approach to scheduling, outmoded workforce and care supply models, priority-based queues, care complexity, reimbursement complexity, and financial and geographic barriers, the report notes.
The report outlines several “basic access principles” to curb wait times including supply and demand matching; immediate attention to the patient’s needs and timing preference at the time of inquiry; need-tailored care with reliable, acceptable alternatives to clinician visit; surge contingencies to ensure timely care; and continuous assessment of changing needs.
“These systems-based approaches will require careful consideration of the full range of components and resources available in the interconnected health system,” the IOM news release says.
A Johns Hopkins School of Medicine survey published in 2013 found that 91 % of all patients arrived to their assigned appointments. However, wait times for doctors averaged 38 minutes including 15 minutes spent alone in the exam room prior to seeing the clinician.
In office wait times are not as frustrating for some as the delay in seeing a physician for an urgent medical problem. A report published by Merritt and Hawkins in 2014 showed that The average appointment wait time to see a family physician ranged from a high of 66 days in Boston to a low of 5 days in Dallas. In the Los Angeles region, patients will wait on average 3-12 days to see their family physician. The average wait time across all markets times for patients to see their primary care physician in 2013 was 20 days.
Now, having given you the bad news, allow me to give you guys and my own staff a big pat on the back. Since we have converted to concierge medicine Unger Primary Care has no wait times for appointments. Dr. Unger is available 24/7 for all of his patients. Yes, I know there was an exception a few weeks ago when Chelsea got married. However, Dr. Unger continues to see walk ins, same day appointment requests, and urgent visits as part of his concierge practice. The office staff is fully aware of the need to continue this important service. We have seen patients after hours for dog bites, lacerations, bronchitis, hives and acute diabetes care.
Our visits are time and cost effective. Private medicine allows us to see fewer patients and provide comprehensive, customized care for their medical conditions. Unlike some physicians who must see 50 patients a day, we see 10-12 and are able to enjoy the time spent with each of our members. We promise to keep each patient informed if their wait time in the office is anticipated to be prolonged for any reason.
Finally, as coordinators of specialty care, Unger Primary Care is an excellent resource for speeding up consultations with other clinicians. We have our ways to get our patients in to see specialists quickly and with minimal hassle.
Please feel free to contact Dr. Unger or his office staff if you have any questions regarding your health or membership services.