Half of Primary Care Practices Remain Closed to New Patients; Wide
Variations in Wait Times Among Massachusetts Counties
Waltham, Mass. – July 15, 2013 -- The Massachusetts Medical Society
today released its ninth annual Patient Access to Care Study, showing that wait
times for new patient appointments with primary care physicians remain long, that
half or more of primary care practices remain closed to new patients, and that
acceptance of the government insurance programs of Medicare and MassHealth
(Medicaid) by physicians remains high in the Commonwealth.
The 2013 survey of 1,137 physician offices is the ninth
annual such study conducted by the statewide physicians’ organization. It examined
three areas:
- wait times for new
patients getting non-emergency appointments with a physician;
- percentages
of physicians accepting new patients; and
- physician acceptance of the
government insurance programs of Medicare and MassHealth.
Seven physician specialties were surveyed for the study: family
medicine, internal medicine (the two major primary care specialties),
cardiology, gastroenterology, obstetrics/gynecology (OB/GYN), orthopedic
surgery, and pediatrics.
Massachusetts Medical Society President Ronald Dunlap, MD,
said, “Our latest survey once again points out a critical characteristic of
health care in the Commonwealth. While we’ve achieved success in securing
insurance coverage for nearly all of our residents, coverage doesn’t guarantee
access to care. The concern is that limited and delayed access can lead to
undesirable results, as people will seek more costly care at emergency rooms, delay
care too long, or not seek care at all.”
Dr. Dunlap also noted that, contrary to reports from other
states, the overwhelming majority of physicians in the state continue to accept
Medicare, and that the percentage of primary care physicians participating in MassHealth
has increased from last year.
Wait Times/Open Practices
Primary Care: The 2013
study shows wait times for new patient appointments with primary care
physicians remain long in the Commonwealth, with the average time to see a
family medicine physician at 39 days (down from 45 days in 2012) and the
average wait time to see an internal medicine physician at 50 days (up from 44
days in 2012). (New patient wait times reflect the total number of calendar
days, including holidays and weekends, between the interview and next available
appointment.)
The study also showed that only about half or less of primary care
practices – 51% of family physicians and 45% of internists - are accepting new
patients in 2013.
For pediatrics – primary care for youngsters up to age 18 –
the average wait time was 25 days, two days longer than last year, with 70% of
pediatric practices accepting new patients, a decrease of 2% from 2012.
Primary Care Trend Data: Medical
Society officials say the trend data for access to primary care shows cause for
concern in all three primary care specialties. While the numbers have
fluctuated from year to year, the percentage of family physicians accepting new
patients has dropped 19% over the last seven years; the percentage of
internists accepting new patients has plunged 21% over the last nine years; and
the percentage of pediatricians accepting new patients has fallen 10% over the
last four years.
Wide Variations Among Counties: Wide variations exist in average wait times from county to county. For
family medicine, Suffolk County has the shortest average time at 16 days, and
Franklin County has the longest average wait time at 106 days.
For internal medicine, average wait times run from 26 days in Worcester
County and 28 days in Barnstable County, to 128 days in Bristol County, 63 days
in Essex County, and 55 days in Norfolk County.
Wait times for new pediatric patients ranged from 13 days in
Bristol County and 16 days in Plymouth County to 38 Days in Suffolk County and
44 days in Berkshire County.
Specialty Care: New
patient wait times for cardiology, gastroenterology, OB/GYN, and orthopedic
surgery were stable or shorter for all specialties except orthopedic surgery. The
biggest changes occurred with gastroenterology, whose wait time decreased 11
days, and with orthopedic surgery, whose wait time increased six days.
The average wait time in 2013 for cardiology is 28 days,
versus 29 days in 2012; for gastroenterology, 33 days, versus 44 days in 2012;
for OB/GYN, 37 days, versus 38 days in 2012; and orthopedic surgery, 22 days,
versus 16 days in 2012.
Access to specialists continues to be much easier than it is
for primary care, with 85% of cardiologists, 92% of gastroenterologists, 84% of
OB/GYNs, and 98% of orthopedic surgeons accepting new patients.
Acceptance of Government Insurance
Medicare: Despite some national reports that physicians are abandoning
Medicare in other areas of the U.S., the overwhelming majority of physicians in
the Commonwealth continue to participate in the Federal insurance program for
seniors age 65 and older.
While primary care has the lowest acceptance rates of Medicare, the
specialties nonetheless maintain high rates of participation: 90% of family
physicians and 85% of internists continue to accept Medicare. Acceptance rates
for the specialties are as follows: orthopedic surgery, 98%; gastroenterology,
97%; cardiology, 96%; and OB/GYN, 94%.
MassHealth (Medicaid): Consistent
with last year’s findings and in line with Medicare, primary care specialties are the least likely to accept MassHealth,
with family medicine at 70% and internal medicine at 66%. However, physician
participation in this program increased by 6% among family physicians
and by 12% among internists in 2013. Pediatrics saw a decrease in acceptance,
at 83% for 2013, down from 86% last year.
Acceptance of MassHealth by specialists saw increases in orthopedic
surgery, to 85%, up from 78%; cardiology, to 85%, up from 83%; and OB/GYN, to 90%,
up from 87%. Gastroenterology dropped to
90%, from 92%.
The 1,137 telephone
interviews with physician offices were conducted between February 28 and April 15
of this year. The survey contains statewide data, as well as data for each of
the 14 counties in the state. Also included are nine-year trend data for five
of the specialties, seven-year trend data for family medicine, and four-year
trend data for pediatricians.
The 2013 Patient Access to Care Study is a component of the Society’s Physician Workforce Study, the
organization’s annual comprehensive look at the state’s physician labor force.
The 2013 Workforce Study, which includes additional information from surveys of
practicing physicians, teaching hospitals, and community hospitals, will be
released later this year.
The Massachusetts Medical Society, with more than 24,000 physicians and student members, is dedicated to educating and advocating for the patients and physicians of Massachusetts. The Society, under the auspices of NEJM Group, publishes the New England Journal of Medicine, a leading global medical journal and web site, and NEJM Journal Watch alerts and publications covering 13 specialties. The Society is also a leader in continuing medical education for health care professionals throughout Massachusetts, conducting a variety of medical education programs for physicians and health care professionals. Founded in 1781, MMS is the oldest continuously operating medical society in the country.
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