Why Getting a Medical Appointment Is Still So Hard
I. The Appointment That Never Comes
In 2024, Victoria Holmes, then 26, faced a four-month wait for a neurology appointment in Washington, DC, where she lived. She sought treatment in her hometown of Dallas instead, telling NBC’s TODAY she was “terrified that there’s something wrong with me” (NBC TODAY, as transcribed by the American Medical Association, September 2024). Her case is one patient’s, not a statistic, but it shows what an appointment total cannot: the person who builds a workaround, or gives up.
Official numbers can look reassuring. NHS England reported 388 million GP appointments over the preceding year, 8.3 million more than the year before, and 73.7% of patients said contacting their practice was easy, up from two-thirds in summer 2024 (NHS England, March 2026).
Yet in UK-wide polling by the Health Foundation and Ipsos in December 2025, 48% of respondents said they had delayed or avoided contacting their GP about a health concern during the previous year. Among those who avoided contacting their GP, 30% did not expect to be offered a suitable appointment, 17% thought contacting the practice would be too difficult, and 14% worried their request would not be taken seriously (Health Foundation and Ipsos, February 2026).
Appointment totals tell us how much care a system delivers. They cannot tell us how many people gave up before getting through the door. That is the gap between activity and access: a system can record more appointments while some patients still struggle to obtain one.
The question is not simply how many appointments health services provide. It is how many people who need care can actually get it, and how long they must wait.
II. A Problem Crossing Borders
Delays affect very different systems, but a wait for a GP is not a wait for a specialist or an operation. Holmes waited for a specialist; the evidence below falls into three kinds of access failure: delay, abandonment and geographic inequality.
Delay. Waiting is the most visible failure, and it appears in several systems. The OECD’s Health at a Glance 2025, drawing on Commonwealth Fund survey data, found that across ten countries 18% of respondents waited more than a week to see a GP or nurse and 57% waited two days or longer, with waits longest in Canada, New Zealand and France. In Canada and the United Kingdom, more than 10% reported waiting over a year for specialist care (OECD). These are 2023 survey results published in the OECD’s 2025 report, not live measures. In Canada, only 27% of adults with a regular primary-care provider could see a health professional the same or next day for a non-urgent need (CIHI), and the Fraser Institute’s 2025 physician survey put the median wait from GP referral to treatment at 28.6 weeks, down from 30 in 2024. That measures the whole pathway, not the time to book a consultation (Fraser Institute, December 2025). In the United States, AMN Healthcare’s 2025 survey, which phoned offices in 15 large metropolitan areas for the first available new-patient slot across six specialties, found an average wait of 31 days, up from 26 in 2022 (AMN Healthcare, 2025). That is a staffing firm’s survey of big cities, not a national measure. Among older adults, only about two in five Medicare beneficiaries who needed a doctor booked an appointment within two days of falling sick (Commonwealth Fund, April 2025).
Abandonment. Some patients stop waiting. In New Zealand, 25.5% of adults and 19.5% of children had a medical problem but did not visit a GP because the wait was too long. The adult figure was more than double the 11.6% recorded in 2021/22, and in December 2025, 26% of general practices were not accepting new enrolments (New Zealand Ministry of Health). In Australia, 26.6% of people aged 15 and over delayed or did not see a GP when needed in 2024/25, down from 29.2% a year earlier (ABS, Patient Experiences 2024/25). In Canada, 9.1% of people reported unmet medical needs due to cost, distance or waiting times in 2024, against an average of 3.4% (OECD).
Geographic inequality. Where a patient lives changes the wait. In Australia, a quarter of people waited longer than they considered acceptable for a GP appointment, rising to 33.6% in outer regional and remote areas against 24.6% in major cities (ABS, Patient Experiences 2024/25).
What the measures show. These measures capture different failures. A long wait means care is delayed; an unmet need means care was not obtained; a decision not to seek an appointment may mean the barrier appeared insurmountable before contact began. The sources also differ in year, question wording and age group, so they cannot be combined into one international ranking. Together, though, they show why appointment supply alone is an incomplete measure of access.
III. Why the Queues Form
Doctor shortages are the usual explanation for long waits, yet headcounts tell only part of the story. Three workforce measures help explain why capacity can stay inadequate: projected shortages, national supply estimates and the time available to provide care.
Projected shortages. The World Health Organization projects a global shortfall of about 11 million health workers by 2030, mostly in low- and lower-middle-income countries (WHO). The Association of American Medical Colleges projects a possible shortage of up to 86,000 US physicians by 2036, a forecast across scenarios rather than a count of vacancies (AAMC, March 2024).
National supply estimates. India’s government estimated a doctor-population ratio of 1:778 in July 2026, based on 1,535,155 registered allopathic doctors and 751,768 registered AYUSH practitioners, assuming that 80% of registered practitioners in both systems are available (Government of India, July 2026). The estimate is not a count of practising doctors and cannot show where they work.
Time available for care. Across OECD countries the average number of doctors per 1,000 people rose from 3.3 in 2013 to 3.9 in 2023. Yet the OECD notes that doctors’ average working hours fell in most countries, so growth in full-time equivalents was more modest than growth in headcount (OECD, Doctors). A higher headcount of doctors does not automatically translate into proportionately more consultations.
The practical constraint is not headcount alone, but the clinical time available in the places where patients need it. Working hours, the mix of professionals, the complexity of cases and the distribution of staff all affect how much care a workforce can deliver. Ageing populations and chronic illness raise the demand on that capacity.
Bottlenecks also spill over: Canada’s health information agency has found that some emergency visits involve conditions potentially manageable in primary care. That does not prove appointment delays caused them, but it shows why routine access matters (CIHI). Booking systems can add to the problem: telephone queues, referral rules and online portals suit some patients and shut out others, yet a smoother process cannot create an appointment where none exists.
IV. The Price of Waiting
The consequences depend on the condition, the delay and the patient, and the sources cited here do not link particular delays to particular health outcomes. They do show who bears the cost of poor access.
Deferred or forgone care. In New Zealand, almost one-third of Pacific adults had not visited a GP because the wait was too long (New Zealand Ministry of Health).
Unequal ability to navigate the system. Disabled adults in New Zealand reported greater barriers related to waiting, cost and transport than non-disabled adults (New Zealand Ministry of Health), and in Australia residents of outer regional and remote areas were more likely than city residents to report unacceptable GP waits (ABS, Patient Experiences 2024/25).
Unequal alternatives. Where public appointments are scarce, those who can pay may go private; others wait, travel or go without. Private care is another route for some, though it says nothing about public access. Holmes’s own workaround depended on having somewhere else to go, which not every patient has. In the United States, better reported access has not meant affordable access. A Commonwealth Fund analysis published in October 2026 found that older adults on Medicare reported some of the best access experiences among ten high-income countries, but more cost-related barriers and higher out-of-pocket spending than older adults elsewhere (Commonwealth Fund, October 2026).
The burden of waiting is therefore unevenly shared. Whether systems are improving access is a separate question.
V. Not Every System Struggles in the Same Way
Some indicators suggest access is improving, but each measures something different.
Unmet need. In the OECD’s 2025 comparison, fewer than 1% of people in Germany, the Netherlands and Czechia reported unmet medical needs due to cost, distance or waiting times in 2024, well below the OECD average of 3.4%. The measure combines several barriers and says little about appointment speed, but it shows that high unmet need is not inevitable (OECD).
Change over time. Australia’s share of people delaying or missing GP care fell between 2023/24 and 2024/25, and the Australian Institute of Health and Welfare reported that 84% of GP attendances were bulk-billed in June 2026, after Medicare changes in November 2025. Bulk billing means the provider accepts the Medicare benefit as full payment. The figure counts attendances, not patients, so it should not be compared with patient-level figures (AIHW, updated August 2026).
Practice-level experience. Even in the United States, where AMN’s survey shows rising waits, a July 2026 poll by the Medical Group Management Association found 46% of groups reporting unchanged new-patient waits from the same period of 2025, 28% longer and 22% shorter (MGMA Stat, July 2026). That records group perceptions, not patient access.
| Country or system | What the cited figures measure | What they do not show |
|---|---|---|
| England and the UK | Ease of contact in England (patient survey); avoidance across the UK (poll) | Whether those who made contact received timely care |
| Canada | Same- or next-day access, unmet need, referral-to-treatment time | Time to book a first consultation |
| Australia | Delayed or missed GP care; bulk-billed attendances | Patient-level bulk billing; specialist waits |
| New Zealand | Avoidance because of waiting | Avoidance because of cost or distance |
| Germany | Combined unmet need (cost, distance, waiting) | How quickly appointments are available |
The evidence does not support a single global verdict. Some indicators improve while others reveal persistent barriers, and each measures a different part of the problem. The more useful question is whether systems can identify unmet demand early enough to respond.
VI. Can the Waiting Game Be Shortened?
The response should begin by identifying where access breaks down. Too little clinical capacity and a booking process that blocks existing capacity call for different remedies. The five areas below are proposals, not interventions this article has shown to work.
- Measuring unmet need. Australia’s and New Zealand’s national surveys already ask who delayed or skipped care, and MGMA identifies the third-next-available appointment as a patient-access measure (MGMA, February 2024). Systems could extend that practice by tracking time to appointment and abandoned attempts, not only volume.
- Primary care capacity. New Zealand’s 26% of general practices not accepting new enrolments in December 2025 suggests that capacity can shrink at the front door. One response is to recruit and retain clinicians where practices are under pressure, so that staffing translates into appointment capacity.
- Team skills. The OECD’s finding that doctors’ average working hours have fallen in most countries, even as headcounts rise, suggests that more doctors alone will not close the gap. Pharmacists, nurse practitioners and other qualified professionals could manage suitable conditions within their scope of practice, protecting doctors’ time for complex cases.
- Access routes. In the UK poll, 17% of those who avoided GP contact thought contacting the practice would be too difficult, which points to booking friction as a deterrent. Online and telephone triage could lower that barrier, provided accessible in-person routes stay open.
- Geographic gaps. The difference in unacceptable-wait rates between remote and city Australians, described above, is the kind of gap that rural clinics, transport support and clinician incentives would target.
Measurement also settles what the evidence alone cannot: whether a given system needs more clinicians, a different mix of them, or an easier way through the door.
Until systems track what patients can actually obtain, appointment totals will keep counting the care delivered and missing the people who never reach it.
