title: Evaluation of wait times for patients seeking cosmetic and reconstructive breast surgery.
abstract: BACKGROUND
  Patients seeking cosmetic or reconstructive procedures in plastic surgery typically face significant wait times for consultations. Little attention has been given to potential disparities in wait times between elective cosmetic and reconstructive procedures. In this initial pilot study, we audited a broad sample of plastic surgery offices within a single state for wait times in initial consultations for both breast reconstruction and breast augmentation.
  
  
  METHODS
  A sample of board-certified plastic surgeons was audited from the American Society of Plastic Surgeons (ASPS) Web site that listed both cosmetic and reconstructive breast surgery. Scripted patient telephone calls were made to 67 plastic surgery clinics within a single state on May 2012. Two calls separated by 7 days were made to each office by the same actor seeking an initial appointment for either breast reconstruction or breast augmentation. Wait times were calculated from the date of the call until the date of appointment offered.
  
  
  RESULTS
  There were 72 paired calls completed on 36 plastic surgery clinics. Significant disparities in appointment wait times existed between elective cosmetic versus reconstructive procedures (P = 0.02). Mean wait times for breast reconstruction consultation (26.1 days) were significantly longer than mean consultation wait times for breast augmentation (20.9 days). Interestingly, 17.9% of offices contacted no longer perform certain procedures currently advertised on the ASPS Web site.
  
  
  CONCLUSIONS
  Disparities exist in access to care between patients seeking elective breast augmentation and reconstruction after mastectomy. Patients seeking breast augmentation have more rapid access to plastic surgeons. This study did not evaluate possible explanations for the observed differences. Potential causes may include physician preference and compensation benefits for cosmetic procedures.
authors.affiliation: From the Department of Surgery, Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
authors.forename: Jason
authors.initials: J
authors.lastname: Silvestre
authors.forename: Christina R
authors.initials: CR
authors.lastname: Bess
authors.forename: John T
authors.initials: JT
authors.lastname: Nguyen
authors.forename: Ahmed M S
authors.initials: AM
authors.lastname: Ibrahim
authors.forename: Priti P
authors.initials: PP
authors.lastname: Patel
authors.forename: Bernard T
authors.initials: BT
authors.lastname: Lee
mesh_terms: D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D016462:Mammaplasty; D010865:Pilot Projects; D013995:Time; D014850:Waiting Lists