Boston Patients Need Patience

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Patients in Boston must wait more than a month on average to see medical specialists, the longest in a survey of 15 major cities, though it has half again as many doctors as the national average.

The shortest wait — eight to 15 days — was in Washington, D.C., according to the survey released this week by the Irving, Texas-based consulting firm Merritt, Hawkins & Associates, which recruits employees for hospitals and doctors' offices.

New patients in Boston wait an average of 37 days to see a cardiologist, 45 days to see an obstetrician-gynecologist and 50 days to see a dermatologist, the survey found.

To compile the data, researchers called 1,062 specialists' offices in 15 cities posing as new patients and requested appointments for nonurgent problems.

The survey did not address why some cities are worse than others. Consulting firm officials and other experts said reasons could include shortages of specialists as older doctors retire or cut back their workload. Patients may also be seeking more appointments because managed care insurers have loosened restrictions on access to specialists, they said.

"Frankly, I'm at a loss to explain it," said Paul Ginsburg, president of The Center for Studying Health System Change, a nonprofit research group based in Washington, D.C. "Boston is a great place to practice. But this is a long-standing pattern."

Massachusetts has 356 doctors for every 100,000 residents, compared with 234 doctors per 100,000 people nationally in 2002, according to the most recent data from the American Medical Association.

The Massachusetts Medical Society suggested that physicians have begun leaving the state because of high malpractice premiums and the steep cost of living.

Dr. Barbara Gilchrest, chief of dermatology at Boston Medical Center, said many doctors work in academic medical centers, where they also conduct research and teach medical students, leaving less time for patient care.