Doctor shortage, patient waits heightened by insurance mandates


State House News Service

Despite years of state efforts to encourage more doctors and patients to pursue primary care, a new study shows primary care doctors in Massachusetts are in short supply, a microcosm of a national problem that researchers say will only worsen as the country’s population ages.

The Massachusetts Medical Society’s physician workforce study found that for the fifth straight year, patients encountered a primary care shortage: half of all practices were closed to new patients, and the number of specialists in dermatology, emergency medicine, family medicine, psychiatry, urology, and other disciplines were insufficient.

Exacerbating the problem — the state’s 2006 health insurance access law, which mandated residents to obtain health insurance. The study said 440,000 residents have been added to insurance rolls, adding stress to the state’s provider network.

“The state’s universal health care plan has improved access to care, but universal coverage and access can only be sustained with a strong physician workforce,” Dr. Alice Coombs, president of the medical society, said in a statement.

The organization’s study looked at teaching hospitals, community hospitals, practicing physicians, medical group and residency programs around the state.

Although 43 percent of doctors expressed satisfaction with their “practice environment,” compared to 41 percent who are dissatisfied, more than half of all doctors said their administrative workload was too high.

According to the study, new primary care patients wait an average of 29 days for family physicians and 53 days for internists, nine days longer than the average wait in 2009.

And the shortage varies by region. Boston, home to clusters of the state’s major teaching hospitals, was the only labor market found to have a sufficient supply of doctors. In Western Massachusetts, more than eight in 10 doctors said their recruitment pool was inadequate.

Community hospitals, researchers found, have had the greatest difficult retaining physicians and filling vacancies. Nearly two-thirds of community hospitals said they had altered the services they offer because of a physician shortage.

In addition, doctors’ “fear of being sued” is a disincentive for prospective and practicing physicians. Four in five neurosurgeons, three-quarters of urologists, seven in 10 emergency medicine practitioners, seven in 10 orthopedists and six in 10 obstetricians said they had changed or limited their practice due to fear of litigation.