GPs are reporting an increase in waiting times for patients for both urgent and routine appointments.
A survey by the National Association of General Practitioners says the percentage of GPs able to provide patients with an urgent appointment within three hours has almost halved since last year.
Now 32% of GPs say they can deliver this service within three hours.
Also, 25% of GPs say they can provide patients with a routine appointment on the same day, compared to 35% last year.
NAGP Chairman Dr Andrew Jordan, said that the rise in waiting times is due to an increase in workload and a lack of resources.
He said that the increase in the number of medical card patients is directly related to the rise in waiting times, given that almost half of the population now have a medical card.
There were 260 GPs involved in the survey.
Meanwhile, new figures show an increase in waiting lists for outpatient clinics and the number waiting for inpatient or day care.
There has been a fall in the number waiting for gastrointestinal checks.
There were 538,309 people waiting for hospital care at the end of last month, compared with 535,800 in October.
Over 440,600 are waiting to be seen by a consultant at an out-patient clinic for the first time.
That is an increase over 1,600 on the October figure.
The number of patients waiting for an inpatient or day case treatment is 81,103 an increase of over 1,400 on the October figure.
The number of people waiting for an endoscopy check is 16,577, down by over 670.
The figures are published by the National Treatment Purchase Fund.
Health Minister Simon Harris has said the number of patients waiting the longest for inpatient or day case care, between 15 and 18 months, was down.
He also said that for the first time, the number of patients waiting over 18 months in this area had also reduced.