Report: Doctor shortage getting worse

By Aaron Wasserman/Daily News staff
http://www.milforddailynews.com

The number of primary care practices closed to new patients is growing as the state sees shortages among those doctors and other specialities, according to a study being released today.

In its annual survey of the labor market for physicians, the Massachusetts Medical Society says patient demand is outstripping supply in primary care. Other specialities with shortages include neurology, oncology and vascular surgery.

Patients are waiting more than a month to see their family physicians or internists, and more than a third of family physicians and nearly half of internists are not accepting new patients, according to the survey.

The society expects this situation will be further stressed by the roughly 440,000 new people who have health care insurance as a result of the state’s health care law. The survey said that only 2 percent of people reported not having health care, compared to 6 percent last year.

“We’re continuing to see a very negative trend around the physician work force in Massachusetts,” said society President Bruce Auerbach yesterday. “Most of the specialties that have been in the ‘severe’ or ‘critical’ shortage category in prior years are again appearing as severe to critical shortages.”

The survey also finds slightly more than half of medical residents are leaving Massachusetts to continue their careers. Also, recruitment time to fill open jobs is lengthening.

“One thing we have against us is the high cost of living in Massachusetts and the low rate of reimbursements for physicians’ services, unless they are part of the Partners network,” said MetroWest Medical Center CEO Andrei Soran, referring to Partners HealthCare. “The combination of those two creates a gap in the income doctors can generate that forces them to look elsewhere.”

The need for primary care doctors has become more acute the past several years, in Massachusetts and nationally.

The state Legislature passed a bill earlier this year that expands enrollment for primary care students at the University of Massachusetts Medical School and offers students debt relief for entering primary care and other specialities in underserved areas.

“We’re certainly quite pleased this has taken such a high profile within the Legislature. There are a number of issues in there that have the potential to begin to address some of the problems we’ve seen,” Auerbach said, citing the debt relief, task forces on specialty shortages and measures to simplify administrative work.

Philip J. Ciaramicoli, CEO of Tri-County Medical Associates, whose 70-doctor practice is affiliated with Milford Regional Medical Center, said the focus needs to remain on shortages of primary care physicians.

“Patients are getting frustrated trying to find a doctor and it’s a serious issue,” he said. “We have to encourage students to go into primary care. It’s the linchpin of the system.”

Ciaramicoli said to make Tri-County Medical Associates more attractive to recruits, it recently installed electronic medical records and is developing a program where primary care doctors are stationed at Milford Regional so they can monitor patients rather than have those doctors working in area offices make daily, lengthy trips to the hospital.

Soran said MetroWest Medical Center has moved aggressively to hire 20 new primary care doctors and 200 overall in the past two years to deal with offices closing to new patients.

Nonetheless, he said, because of the high cost of living locally, “hospitals are in a precarious position where they have to subsidize the recruitment and retention of physicians.”

Also in its survey, the Massachusetts Medical Society reports community hospitals are having more difficulty filling doctor vacancies than teaching ones. Auerbach hypothesized that is because academic hospitals have several years “to showcase themselves and do everything in their power to retain the physicians they wish to retain.”

Aaron Wasserman may be reached at 508-634-7546 or awasserm@cnc.com.

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