Availability of outpatient care from psychiatrists: a simulated-patient study in three U.S. cities

Psychiatr Serv. 2015 Jan 1;66(1):94-6. doi: 10.1176/appi.ps.201400051. Epub 2014 Oct 31.


Objectives: The study examined availability of psychiatrists for outpatient appointments in three U.S. cities.

Methods: Posing as patients, investigators called 360 psychiatrists listed in a major insurer's database in Boston, Houston, and Chicago (N=120 per city) and attempted to make appointments. Callers claimed to have Blue Cross Blue Shield or Medicare or said they would pay out of pocket (N=120 per payer type, divided evenly across cities).

Results: In round 1 of calling, investigators were able to reach 119 of the 360 psychiatrists (33%). Of 216 unanswered calls, 36% were returned. After two calling rounds, appointments were made with 93 psychiatrists (26%). Significant differences were noted between cities but not between payer type.

Conclusions: Obtaining outpatient appointments with psychiatrists in three cities was difficult, irrespective of payer. RESULTS suggest that expanding insurance coverage alone may do little to improve access to psychiatrists-or worse, expansion might further overwhelm the capacity of available services.

MeSH terms

  • Ambulatory Care / standards*
  • Ambulatory Care / statistics & numerical data
  • Appointments and Schedules*
  • Boston
  • Chicago
  • Health Services Accessibility / standards*
  • Health Services Accessibility / statistics & numerical data
  • Humans
  • Psychiatry / standards*
  • Psychiatry / statistics & numerical data
  • Texas