Northern Ireland's hospital waiting lists have climbed by more than 40% in the last eight years, according to a report from the Northern Ireland Audit Office.
It said if only the last few years were taken into account, then overall there has been a fall.
However, comparing Northern Ireland with elsewhere in the UK, Thursday's analysis shows the province has the longest queues.
It said the time from when a patient saw their GP to getting into hospital, as well as list time, should be measured.
Dr Brian Patterson, chairman of the BMA's GPs' Committee in Northern Ireland, said he was concerned that figures for recent years showing an improvement in waiting times were camouflaging the real situation.
"I think the report very clearly says what we should do is measure the time from when a GP decides the patient should go to hospital to when they actually get the care they need," he said.
Dr Brian Patterson: Figures camouflage real situation
"This is where the camouflaging is going on.
"There is a huge pool of people who are waiting up to three years to get an opinion from a hospital just to get on a waiting list."
William McKee, chief executive of the Royal Group of Hospitals, said the problems stemmed from funding cuts ordered by Malcolm Moss, NIO health minister in the last Conservative government - a policy continued by Labour.
"So, unlike the rest of the UK, we had three difficult funding years in the late 1990s: that is when things started to go badly wrong," he said.
"We simply didn't have enough money to do all the work needed, and like other trusts, we concentrated on emergency work, and unfortunately waiting lists grew."
The Northern Ireland Chest, Heart and Stroke Association condemned the figures.
Chief Executive Andrew Dougal said: "The Audit Office report shows that Northern Ireland is the worst place in the UK to live when waiting for in-patient treatment in hospital.
"It is disgraceful that the number of people waiting is 68% higher than in England. Since 1996, our waiting lists have increased by a shocking 42%.
"We were horrified to discover that five patients in Northern Ireland had to wait more than a year for cardiac surgery, while in England and Wales nobody had to wait 12 months."
Jane Graham, chief executive of patients' watchdog the Eastern Health Council, said she was worried about funding for health care next year.
"We are being told that there is not going to be even enough money to maintain existing services, so any expansion or development is going to be put in jeopardy," she said.
A Department of Health spokesman said substantial progress had been made in recent years to improve the management of waiting lists.
"Between September 2002 and June 2004 the number of total waiters reduced by over 15%, and the number of patients waiting longer than 18 months reduced by almost 65%," said the spokesman.