Open Access Highly Accessed Research article

Waiting to see the specialist: patient and provider characteristics of wait times from primary to specialty care

Liisa Jaakkimainen1*, Richard Glazier1, Jan Barnsley2, Erin Salkeld3, Hong Lu1 and Karen Tu1

Author Affiliations

1 Institute for Clinical Evaluative Sciences, 2075 Bayview Ave, G wing, Toronto, Ontario M4N 3M5, Canada

2 Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Suite 425, Toronto, Ontario M5T 3M6, Canada

3 Central Local Health Integration Network, 60 Renfrew Drive, Suite 300, Markham, Ontario L3R 0E1, Canada

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BMC Family Practice 2014, 15:16  doi:10.1186/1471-2296-15-16

Published: 25 January 2014



Wait times are an important measure of access to various health care sectors and from a patient’s perspective include several stages in their care. While mechanisms to improve wait times from specialty care have been developed across Canada, little is known about wait times from primary to specialty care. Our objectives were to calculate the wait times from when a referral is made by a family physician (FP) to when a patient sees a specialist physician and examine patient and provider factors related to these wait times.


Our study used the Electronic Medical Record Administrative data Linked Database (EMRALD) which is a linkage of FP electronic medical record (EMR) data to the Ontario, Canada administrative data. The EMR referral date was linked to the administrative physician claims date to calculate the wait times. Patient age, sex, socioeconomic status, comorbidity and FP continuity of care and physician age, sex, practice location, practice size and participation in a primary care delivery model were examined with respect to wait times.


The median waits from medical specialists ranged from 39 to 76 days and for surgical specialists from 33 days to 66 days. With a few exceptions, patient factors were not associated with wait times from primary care to specialty care. Similarly physician factors were not consistently associated with wait times, except for FP practice location and size.


Actual wait times for a referral from a FP to seeing a specialist physician are longer than those reported by physician surveys. Wait times from primary to specialty care need to be included in the calculation of surgical and diagnostic wait time benchmarks in Canada.