If you’ve been waiting months for your next doctor’s appointment, you’re certainly not alone. This is an increasingly common woe for many in our CreakyJoints.org community (and beyond).
According to a 2022 survey from AMN Healthcare and its physician search division, Merritt Hawkins, the time it takes to schedule an appointment in 15 major metropolitan areas has increased by 8 percent since 2017 and by 24 percent since 2004. On average, it now takes 26 days to get a new patient physician appointment in these 15 largest cities in the United States.
However, it’s worth noting that these figures only apply to large cities, and doctors may be even scarcer in rural areas.
We spoke with doctors to understand why it’s challenging to secure appointments currently and to learn what to do if you’re unable to get one.
The Shortage of Doctors
Put plainly: There aren’t enough doctors to keep up with demand. Older doctors are retiring and there aren’t enough fellowship opportunities for new doctors interested in specialties like rheumatology.
“In the Northeast, there’s about one rheumatologist for every 40,000 people,” says Christopher Morris, MD, a rheumatologist in Kingsport, Tenn. “In the Southeast, there’s one rheumatologist for every 80,000 people.”
As the demand for doctor’s appointments continues to exceed supply, many patients find themselves waiting weeks or even months before they can see their family physician. And doctors are getting older and retiring, too.
Almost 45 percent of all physicians are over 55 years old, per a white paper from Definitive Healthcare. Meanwhile, the average age of physicians in specialties like chiropractic or foot and ankle surgery is 61.
“A lot of us are starting to retire,” says Dr. Morris. “They’re not keeping up with the number of rheumatologists retiring, which is a big problem.”
The other aspect of this bottleneck is the lack of fellowship opportunities for those coming out of residency who want to specialize in rheumatology. “There’s a shortage of rheumatologists in this country and a shortage of training slots for them, so you’re turning out fewer than are needed,” adds Dr. Morris.
Higher Demand for Health Care
The experts we spoke to also pointed to the overburdened medical facilities that are unable to keep up with the rising health care needs of our population. The surge in demand created by the COVID-19 pandemic made this problem increasingly evident.
“Some doctors had to limit their hours or even temporarily close due to staff shortages, budget constraints, or changing insurance policies, further exacerbating the issue,” says Sony Sherpa, MD, a holistic physician from Nature’s Rise, an organic wellness company. “We also have an aging population that requires increased medical attention, further increasing the demand for health care.”
In 2020, people aged 65 and over represented 17 percent of the population — and that’s expected to grow to 22 percent by 2040, per a report from the Administration on Aging.
What’s more, six in 10 adults in the United States have a chronic disease and 4 in 10 adults have two or more chronic diseases, per the U.S. Centers for Disease Control and Prevention.
The U.S. has the highest rate of people with multiple chronic conditions compared to other high-income countries — but Americans have among the lowest rate of practicing physicians and hospital beds per 1,000 people, per the The Commonwealth Fund.
“You have an aging population that’s living longer, but with more chronic illnesses like joint pain, arthritis, back pain, and autoimmune issues that are now epidemic,” says Aly Cohen, MD, an integrative rheumatologist and environmental health expert in Princeton, New Jersey, and founder of The Smart Human health and wellness platform on social media. “There’s not going to be enough doctors, including rheumatologists, to really understand those diseases and get to them quickly.”
Health Insurance Limitations
Some doctors also point to limited in-network options for health insurance plans.
“As patients try to find an affordable doctor or health facility that is within their insurance coverage, choices become limited and wait times longer,” says Dr. Sherpa. “The rise in demand for doctor appointments means more paperwork for health care offices, leading to even further delays.”
Plus, the payments made to physicians from Medicare have not kept up with rising costs — which means doctors are paid less for their work. When adjusted for inflation, Medicare physician payments declined by 26 percent from 2001 to 2023, per the American Medical Association (AMA).
“Physicians caring for Medicare beneficiaries continue to grapple with a statutory freeze in annual Medicare physician payments until 2026, when updates resume at a rate of only 0.25 percent a year indefinitely, well below the rate of medical or consumer-price index inflation,” per a statement from the AMA.
What to Do If You Have Trouble Booking an Appointment
If your specialist tells you there’s a long wait for your next appointment, not all hope is lost. Here are a few steps you can take if you can’t book a doctor’s visit in a timely manner.
Call Your Health Care Plan
Your health plan may be required to help you book an appointment within a reasonable period of time, depending on where you live. For instance, California law requires that health plans provide timely access to care — meaning you have the right to see a specialty physician within 15 days and a primary care physician within 10 days.
If you’re having trouble booking an appointment, call your health plan, which may help you get a timely appointment with the appropriate provider.
Explore Telemedicine Options
Also consider if your appointment can be done virtually or not, especially if you’re in an area where an in-person office is difficult to get to.
Telehealth may be particularly helpful for follow-up visits, per the U.S. Department of Health and Human Services. It provides an opportunity for your doctor to further engage with you and perform more assessments, review your follow-up instructions about medications, and encourage you to schedule any referral appointments (if they’re needed).
Ask for a Referral to Another Provider
If your doctor is booked up for the foreseeable future, ask if they can recommend another in-network doctor for you.
You may also try to access a cash-based practice, if that’s an option for you — which could help you get an appointment sooner. This is a practice that accepts cash, credit cards, debit cards, or checks (not just insurance). An increasing number of medical services, from MRIs to blood work to outpatient surgery, may cost less if you pay the provider out of your own pocket rather than involving your insurer, per Consumer Reports.
However, keep in mind that these expenses typically won’t count toward your deductible — and may also not be counted toward your out-of-pocket maximum, which caps the full amount you owe for deductibles, copays, and co-insurance.
Consider a Nurse Practitioner
If there aren’t any doctors available for you to see about, say, flu-like symptoms or a yearly check-up/routine screening, check if a nurse practitioner can see you.
Like doctors, nurse practitioners can diagnose and treat acute conditions, order diagnostic tests like X-rays or lab work, manage your overall care, serve as a primary care provider, be board-certified in specialties like family practice or women’s health, and write prescriptions (though this may be limited based on the state you live in), per Cedars-Sinai.
Nurse practitioners have more training than a registered nurse, but they receive less training than a doctor. They focus on disease prevention and health education and counseling — and often have more availability than doctors.
Utilize Urgent Care Clinics
There are some instances in which it’s important not to wait for an appointment: Skip the wait and go to urgent care if you’re experiencing symptoms such as hot and swollen joints, high fever with rash, severe abdominal pain, a severe and unusual disease flare, and sudden spine pain.
Urgent care clinics are often a better use of your time and money than the emergency room, unless you’re experiencing a life-threatening condition, per UChicago Medicine. They typically have far shorter wait times and cost less than a traditional hospital ER visit. However, a trip to the emergency room or a 911 call is warranted if you experience a severe injury, allergic reaction, or signs of a possible stroke or heart attack.
Book Your Next Appointment Before You Leave Your Appointment
When you’re asked if you want to book your next appointment at the end of your current one, say yes! If you’re not able to confirm your schedule at the doctor’s office, then use online booking as soon as possible after your appointment.
With online booking, you may be able to see time slots available earlier or later in the day that you don’t think to ask about when speaking to the doctor’s office in person.
Certain issues like joint pain are frustrating, but you may be able to wait to see a doctor for them. It’s also key to wait for your doctor to help you interpret and shape takeaways from labs that were ordered for you.
And during this time of medical care shortages, do your best to be flexible: Be willing to try a new doctor or nurse practitioner, open up your schedule to prioritize your health (even if it means an early morning or evening appointment), and explore telemedicine when it’s appropriate.
Advocate for Yourself
In addition to calling your health plan and exercising any rights you may have to get a timely appointment, make the most of your appointment when you’re there. Write a list of questions ahead of time, give a detailed report of your symptoms, and bring a loved one with you if you can. This is all a part of championing for yourself to get the best care possible.
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2021 Profile of Older Americans. Administration on Aging. November 2022. https://acl.gov/sites/default/files/Profile%20of%20OA/2021%20Profile%20of%20OA/2021ProfileOlderAmericans_508.pdf.
AMN Healthcare Survey: Physician Appointment Wait Times Up 8% from 2017, Up 24% from 2004. AMN Healthcare. September 12, 2022. https://www.merritthawkins.com/physician-appointment-wait-times-up-from-2017/.
Chronic Diseases in America. National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP). U.S. Centers for Disease Control and Prevention. December 13, 2022. https://www.cdc.gov/chronicdisease/resources/infographic/chronic-diseases.htm.
Addressing the healthcare staffing shortage. Definitive Healthcare. October 2022. https://www.definitivehc.com/resources/research/healthcare-staffing-shortage.
How Paying Your Doctor in Cash Could Save You Money. Consumer Reports. May 4, 2018. https://www.consumerreports.org/healthcare-costs/how-paying-your-doctor-in-cash-could-save-you-money/.
Interview with Aly Cohen, MD, an integrative rheumatologist and environmental health expert in Princeton, New Jersey, and founder of The Smart Human health and wellness platform on social media.
Interview with Christopher Morris, MD, a rheumatologist in Kingsport, Tenn.
Interview with Sony Sherpa, MD, a holistic physician from Nature’s Rise, an organic wellness company.
Medicare physician pay must track inflation—every year. American Medical Association. March 16, 2023. https://www.ama-assn.org/practice-management/medicare-medicaid/medicare-physician-pay-must-track-inflation-every-year.
Timely Access to Care. California Department of Managed Health Care. Accessed April 21, 2023. https://www.dmhc.ca.gov/healthcareincalifornia/yourhealthcarerights/timelyaccesstocare.aspx.
U.S. Health Care from a Global Perspective, 2022: Accelerating Spending, Worsening Outcomes. The Commonwealth Fund. January 31, 2023. https://www.commonwealthfund.org/publications/issue-briefs/2023/jan/us-health-care-global-perspective-2022.