Can I find a doctor? Availability of primary care physicians in the San Francisco Bay Area.

OBJECTIVES

Primary care physicians function as "gatekeepers" in many managed care systems. With the rapid growth of managed care enrollment, it is crucial that patients have adequate access to primary care physicians. We investigated factors associated with new-patient appointment availability of primary care physicians in the San Francisco Bay Area.

STUDY DESIGN

Observational cohort.

POPULATION

Cross-sectional survey of primary care physician offices in 2 San Francisco Bay Area counties (n=438).

OUTCOMES MEASURED

New-patient appointment availability.

RESULTS

Seventy-five percent of primary care physicians participating in managed care had an appointment available for a new patient. Appointments were more likely to be available with primary care physicians who had been in practice for 10 years or less (odds ratio [OR]=4.2; 95% confidence interval [CI], 1.7-10.3), compared with more established physicians; and with primary care physicians who had graduated from a medical school outside of the United States (OR=3.5; 95% CI, 1.7-7.3), compared with US graduates. Appointments within 30 days were less available with female primary care physicians (OR=0.4; 95% CI, 0.2-0.7) than for male primary care physicians.

CONCLUSIONS

The limited availability of appointments for new patients may create barriers to primary care in the San Francisco Bay Area, a region with high managed-care penetration.