The Massachusetts Medical Society's annual Physician Workforce Study shows a fifth consecutive year of primary care physician shortages as well as shortages in 10 of 18 physician specialties across the state.
The 2010 study is the society’s ninth annual look at the commonwealth's physician workforce. The study surveys teaching hospitals, community hospitals, practicing physicians, medical directors of medical groups and resident and fellow programs.
“The findings from this latest analysis,” said Alice Coombs, MD, president of the Massachusetts Medical Society, “clearly show how fragile access to care for patients is across the entire commonwealth.
Coombs said the commonwealth's universal healthcare plan has improved access to care, but universal coverage can only be sustained with a strong physician workforce. She emphasized the need for careful consideration of any future cost control measures, particularly with respect to establishing a fair system of payment reform.
“If physicians think that the viability of their practices is threatened or unsustainable under a new payment system, Massachusetts may encounter further problems with recruitment and retention,” she said.
The report’s key findings include:
- The primary care specialties of family medicine and internal medicine are in critically short supply, the fifth consecutive year of shortages for these specialties.
- 10 of 18 specialties studied have been found in short supply, three more than last year.
- 54 percent of family medicine physicians and 49 percent of internal medicine physicians are not accepting new patients.
- Wait times for new patients for primary care average 29 days for family physicians and 53 days for internists.
- With the exception of Boston, physician shortages exist in all regional labor markets across the commonwealth.
- Community hospitals continue to be the most seriously affected by physician shortages, with difficulty filling vacancies and retaining physicians resulting in the need to alter services and change staffing patterns.
- The fear of being sued remains a substantial negative influence on the practice of medicine, affecting access to and availability of physician services.
Coombs said the physician workforce in Massachusetts continues to be affected by a lingering poor practice environment in the state. The society's Physician Practice Environment Index, a statistical indicator of nine factors that shape the environment in which physicians provide patient care, dropped 0.8 percent in 2009 and has fallen in 16 of the past 18 years.
Since 1992, the Massachusetts Index has declined by 26.4 percent, significantly more than the 21.3 percent decline in the comparable national index. The index takes into account such factors as the cost of maintaining a practice, median physician income, liability insurance rates and hours spent on patient care.