Physician shortage in Massachusetts continues to squeeze primary care
■ General surgery and internal and family medicine are among the hardest-hit specialties.
Massachusetts is facing severe or critical shortages of doctors in eight specialties, including a deficiency of primary care physicians for the sixth year, a survey shows.
Internal medicine, psychiatry and urology are seeing critical shortages, according to the 2011 Massachusetts Medical Society's "Physician Workforce Study," released in September. Dermatology, family medicine, general surgery, neurosurgery and orthopedics are seeing severe shortages, according to the 10th annual MMS report, which evaluated 18 specialties. Researchers surveyed practicing physicians, residents and fellows across the state.
Neurosurgery is the only specialty new to the shortage list this year. However, three specialties on the list in 2010 did not make it this year: emergency medicine, neurology and vascular surgery (link).
MMS President Lynda M. Young, MD, said a long-term goal is to have more physicians enter primary care. Doctors and others are working toward that goal in various ways. For example, as the economy improves, health professionals are seeking ways to increase payments to primary care physicians.
Dr. Young said the study shows the difficulty in recruiting doctors and "a fear of litigation that affects access and availability, and dissatisfaction with a practice environment that continues to deteriorate."
"The good news is that physicians, policymakers and health officials are working to address critical concerns," she said.
The findings in Massachusetts reflect what is going on nationwide.
In recent years, Wisconsin and Connecticut have experienced physician shortages. A 2010 work force study by the Assn. of American Medical Colleges estimated that the country will be 62,900 doctors short in 2015 and 91,500 doctors short by 2020. AAMC officials attributed the gap to increased demands from baby boomers and the health system reform law's expanded coverage, which is expected to bring health insurance to 32 million uninsured Americans.
In addition to analyzing the state's work force, the Massachusetts study asked 1,071 practicing physicians their thoughts about payment systems. Among the findings:
- 57% were familiar with global payment systems. Among these doctors, 45% were likely to participate voluntarily in such a system, and 55% were not likely to participate.
- 58% were familiar with accountable care organizations. Among these doctors, 59% were likely to participate voluntarily in an ACO, and 41% were not likely to participate.
- 41% preferred a single-payer national health care system as the best option for the U.S, up from 34% last year.
- 59% believed the best option for the U.S. health care system was something other than single payer. For example, 17% said the Patient Protection and Affordable Care Act was the best option, and 23% preferred public and private plans with a public buy-in option for businesses and individuals.