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The number of days a patient had to wait for a new appointment in four specialties -- ob/gyn, cardiology, orthopedic surgery, and dermatology -- continues to increase, according to a new survey.

Among 15 major metropolitan areas, the time it takes to schedule a new appointment increased by 8% since 2017 and by 24% since 2004, reported.

The average number of days a person had to wait for a new patient appointment was 26 days in cities including New York City, Los Angeles, and Seattle. Overall, new appointment wait times increased from 24.1 days on average in 2017 and 21 days on average in 2004.

The survey also found that wait times were not equal across the specialties. The average wait time for ob/gyn appointments was 31.4 days, a 19% increase from the 2017 survey data (26.4 days). New patients had to wait an average of 26.6 days for cardiology appointments -- a 26% increase from 2017 (21.1 days) -- and 16.9 days for orthopedic surgery appointments -- an increase of 48% from 2017 (11.4 days). Wait times for dermatology appointments averaged 34.5 days, a 7% increase from 2017 (32.3 days).

The only specialty to see a decrease in wait times was family medicine, which averaged 20.6 days for an appointment -- a decrease of 30% from 2017 (29.3 days).

Increased wait times are likely a sign of growing demand, said Tom Florence, the president of AMN Healthcare's physician search division, noting that the data also represent an evolving shortage in the capacity to supply healthcare services across the country.

"Physician appointment wait times are the longest they have been since we began conducting the survey," Florence said. "Longer physician appointment wait times are a significant indicator that the nation is experiencing a growing shortage of physicians."

The projected data on physician shortages have loomed on the healthcare horizon for more than a decade, with new analyses updating the prospective depths of the crisis every year, but these survey results represent a unique barometer of physician shortages affecting the country now, according to Atul Grover, MD, PhD, the executive director of the Association of American Medical Colleges' (AAMC) Research and Action Institute.

"We're kind of at this tipping point," Grover told MedPage Today.

He highlighted that the wait times for these surveyed specialties match what his organization has found in reports on physician shortages. In , the AAMC found that specialty physicians, including cardiologists, ob/gyn physicians, and orthopedic surgeons, would fall short of expected demand by up to 77,000 physicians in 2034.

Another factor driving up demand and shifting a physician shortage crisis into the present is an aging U.S. population, Grover said. Primary care physicians, such as those practicing family, pediatric, or geriatric medicine, are projected to fall short of demand for their services by up to 48,000 physicans in 2034.

He noted that many Americans are living longer lives that require more healthcare services over time than previous generations, with the AAMC report projecting that the U.S. population over the age of 65 is expected to grow 42.4% by 2034.

"We all live longer," Grover said. "And that just means that we live to our second or third cancer. We live through three stents and then eventually get old enough that we need a bypass anyway. Those are good things, but they don't decrease the need for specialists. It just increases the demand over a lifetime for all these different types of care."

"Everybody is going to feel it, but it's going to affect people most who are the most vulnerable," he added. "People who are already financially under-resourced, people who are on Medicaid, people with multiple chronic illnesses that don't have a lot of money to see a lot of specialists -- they are the ones that are going to suffer the most."

The wait times are an indicator that these shortages are already affecting patients and the healthcare system overall, according to Grover. And he noted that the Merritt Hawkins' survey was only looking at data in major cities, which tend to fair better than rural communities where specialty physicians are fewer and farther apart.

In fact, the AAMC report highlighted that if marginalized populations, including people in rural communities and those are uninsured, had equitable access to healthcare services, then the U.S. would need about 180,000 more physicians to meet that demand.

These numbers are not necessarily reflected in the survey data from the Merritt Hawkins report, but Florence highlighted that the results show a trend line for the rest of the country.

"Major cities like those included in the survey have some of the highest ratios of physicians per capita in the country, yet physician appointment wait times are increasing," Florence said. "It's a sobering sign for the rest of the country when even patients in large cities must wait weeks to see a physician."

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