Wednesday, April 16, 2014
The Associated Press
BOSTON – The state is experiencing a critical shortage of primary care physicians and stark geographical differences in the recruitment and retention of doctors, a new report says.
On a more positive note, the annual Physician Workforce Study, set for release by the Massachusetts Medical Society on Wednesday, also found a growing number of doctors willing to embrace cost-saving techniques such as accountable-care organizations and global payments.
Also, more than three-quarters of the physicians surveyed were happy in their careers, though less than half expressed full satisfaction with Massachusetts as a place to practice medicine, the survey found.
"The supply of physicians in the state remains under stress, notably with primary care, and recruitment and retention continue to be difficult, especially for less populated areas of the state," MMS president Dr. Ronald Dunlap said in a statement accompanying the 2013 survey of more than 8,000 doctors.
He said those factors "affect patient access to care."
The report found critical or severe shortages in family medicine and internal medicine, the two primary care specialties, for an eighth consecutive year. Primary care doctors are viewed as critical to the health care system for their role in preventative care and referrals to other medical specialties.
The findings reflect a report from the doctors' group in July that showed about half of the state's primary care practices were closed to new patients and there were lengthy wait times to see primary care physicians.
Regional disparities in the hiring and retention of doctors continued to be a pressing issue, according to the study.
For example, 78 percent of respondents in Berkshire County and 75 percent in the Springfield area cited an inadequate pool from which to recruit physicians, and about 50 percent in both regions said it was difficult to retain staff.
In the Worcester region, 57 percent reported a less than adequate pool of physicians, 43 percent said it was difficult to retain staff and 30 percent experienced significant difficulties in filling vacancies.
As a result, health care organizations in those markets often were forced to adjust staffing or alter services, the report found.
By contrast, only 18 percent of respondents in greater Boston said they had trouble filling vacancies and less than 33 percent had to adjust staffing or services.
Nearly half the doctors surveyed cited familiarity with the state's 2012 health care cost containment law, which seeks to save the state up to $200 billion in health care costs over the next 15 years, in part through accountable-care organizations, which take a more coordinated approach to medicine.
Seventy-one percent of physicians said they were familiar with ACOs, and 42 percent said they were already part of one.
Nearly 60 percent of doctors said they were familiar with global payments, fixed fees paid to groups of providers in lieu of the more common fee-for-service approach that critics say encourages expensive or unnecessary tests. Fifty-four percent said they were likely to participate in a voluntary global payment system, a 5 percent increase over last year.