Expectations and realities in primary care appointment access in the United States: A national study

OBJECTIVE: While patients expect timely appointments, little is known about how accurately patient expectations reflect the realities of access to a primary care physician. METHODS: We deployed a national survey (N = 6119, conducted in 2021) to measure patient expectations and a separate national field experiment (N = 11,016, conducted between 2013 and 2016) where trained research assistants called physician offices seeking an appointment to measure physician availability. RESULTS: Using multivariate regression analyses, we find that patients expected to call 1.9 physicians to secure an appointment, consistent with an appointment offer rate of 49%. However, expectations of 5.4 days wait to an appointment were below the 28.5 wait days offered. Male respondents expected to wait 1.9 days longer and were offered appointments 2.0 days later. However, despite not expecting fewer appointments, Black and Hispanic patients were 2 percentage points and 3 percentage points less likely to be offered appointments, respectively. CONCLUSIONS: Respondents on average were able to accurately characterize overall primary care appointment access, but were unable to accurately describe how long one has to wait until being seen by a physician. Discrepancies between expectations and access in primary care may lead to low patient satisfaction, overuse of emergency rooms, or abandoned attempts to obtain care.