A health care disparity appears to widen

Study of wait times to see a physician could signal a growing gap over access based on income and insurance availability

It takes less time for a new patient to see a doctor in Houston than the national average, but a health care study also finds the percentage of physicians who accept Medicaid and Medicare remains much lower than in other major cities.

Taken together, the two measurements could signal a widening disparity in access to health care based on income and insurance availability in Houston, said Phillip Miller, vice president of communications for Merritt Hawkins, a leading national physician search and health care consulting firm.

The findings are part of his firm’s 2017 Survey of Physician Appointment Wait Times and Medicare and Medicaid Acceptance released Monday.

In Houston, the average wait time for a new patient appointment among the five polled specialties is 19.6 days, beating the national average of 24 days. The shortest average wait time with the same criteria was in Dallas at 14.8 days. The longest was in Boston at 52 days.

Still, the time to see a doctor can vary widely even within the same city.

For instance, in Houston it can take as little as one day or as many as 180 for a first-time patient to see a family practitioner.

Other specialties surveyed were cardiology, dermatology, obstetrics-gynecology and orthopedic surgery. In Houston, the quickest average time for a new patient to get an appointment was with an orthopedic surgeon, with wait times ranging from one to 30 days.

While Houston patients fared better than in other major U.S. cities, the study showed they were not immune to the national trend of creeping wait times. In 2014 the average wait across specialties for new patients in Houston was 19 days; in 2009 it was 17.

Nationally, the wait time has grown 30 percent since 2014, the study showed.

“Physician wait times are the longest they have been since we began conducting the survey,” Merritt Hawkins president Mark Smith said in a statement, which he described as an indication the “nation is experiencing a short-

age of physicians.”

The survey of 1,414 physicians also asked how often they accept Medicaid and Medicare. The average rate of Medicare acceptance in the large cities was 85 percent and 53 percent for Medicaid.

Houston falls behind in both. Only 69 percent of polled doctors accept Medicare — the worst rate among cities in the study. Those accepting Medicaid were 37 percent, with Houston tying Miami as the second worst in the study. Only Dallas had a lower acceptance rate with 17 percent.

Miller speculated that the lower acceptance of the federal programs among physicians in Texas suggests it could be a combination of relatively low unemployment rates and generous employer insurance plans for workers. That allows doctors to be choosy about accepting payments with lower reimbursement rates.

“There is financial incentive to see insured patients,” Miller said, referring to doctors in Houston and Dallas. “They don’t have to make up a certain percentage of their practices with poorer paying plans.”

The findings offer only a snapshot, but the study said the overall picture points to a worrisome trend of doctor shortages and the need to expand accessibility as the nation’s health care system continues to evolve.