Longer patient wait times, continued difficult access to
primary care physicians,and gaps in physician acceptance of
government coverage
Contact: Richard Gulla
Tel: 781-434-7101
E-mail: rgulla@mms.org
Waltham, Mass. -- May 9, 2011 -- A 2011 survey about patient
access to health care in the Commonwealth shows more than half of
primary care practices closed to new patients, longer wait times to
get appointments with primary and specialty physicians, and
significant variations in physician acceptance of government and
government-related insurance products.
The survey of physicians by the Massachusetts Medical Society is
part of the Society's annual Physician Workforce Study and is being
released today as hundreds of physicians gather on Beacon Hill to
meet with legislators at Doctors Day at the State House.
The survey included seven physician specialties and 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 Medicare, MassHealth (Medicaid), and
Commonwealth Care and Commonwealth Choice, the latter two offered
by The Health Connector, an independent state agency that helps
Massachusetts residents find health care coverage and which was
established as part of the state's health care reform five years
ago.
The specialties surveyed included internal medicine, family
medicine, cardiology, gastroenterology, orthopedic surgery,
obstetrics and gynecology, and pediatrics.
Alice Coombs, M.D., President of the Massachusetts Medical
Society, said the survey results point out a critical
characteristic of health care in the Commonwealth, one that
physicians have known for some time.
"Massachusetts has made great strides in securing insurance
coverage for its citizens," said Dr. Coombs, "but insurance
coverage doesn't equal access to care. We still have much work to
do to reduce wait times and widen access. This has important
implications for health care cost control, as difficulty or delay
with routine access to care leads people to seek other options,
such as the emergency room, which is much more costly."
Dr. Coombs cited a recent survey released in April by the
American College of Emergency Physicians that showed emergency room
usage in the state has risen, due in part to physician
shortages.
In addition to data for the state as a whole, the survey includes
data for each of the 14 counties in the Commonwealth, five-year
trend data for six of the specialties, and two-year trend data for
pediatricians.
ACCESS TO PRIMARY CARE PHYSICIANS
Access to primary care physicians is becoming more
restricted, as more than half of primary care practices - 51% of
internists and 53% of family physicians - are not accepting new
patients. These figures remain close to those of last year's
survey which showed 49% of internists and 54% of family physicians
not accepting new patients.
Medical Society officials say the percentage of practices closed
to new patients reflects the persistent shortages of primary care
physicians in the Commonwealth. For five consecutive years, the
Medical Society has recorded critical and severe shortages of both
internists and family physicians.
WAIT TIMES FOR NEW PATIENTS
Primary Care Long wait times continue for the primary care
physicians of internal medicine and family medicine who are
accepting new patients. The average wait time for an appointment
for internal medicine is 48 days, five days shorter than last year,
and the average wait time for family medicine is 36 days, up 7
days. Internal medicine was the only specialty reporting a shorter
wait time, yet at 48 days it has the longest wait time of any of
the seven specialties surveyed.
The average wait time for pediatricians - primary care for
youngsters up to age 18 - was 24 days, the same as last year.
Seventy-three percent of pediatricians are accepting new
patients.
Specialty Care All four specialties reported
longer wait times: gastroenterologists, 43 days, up from 36 days;
obstetricians/gynecologists, 41 days, up from 34 days; orthopedic
surgeons, 26 days, up from 17 days; and cardiology, 28 days, up
from 26 days.
Access to specialists is easier than primary care, with 82% of
cardiologists, 85% of obstetricians/ gynecologists, 95% of
gastroenterologists, and 97% of orthopedic surgeons, accepting new
patients.
ACCEPTANCE OF GOVERNMENT and GOVERNMENT-RELATED
INSURANCE
Physician acceptance of government and government-related
insurance products varies widely, within primary care and between
primary care and specialties.
Primary Care The gap between primary care
physicians accepting Medicare and MassHealth is striking. While
most internists (85%) and family physicians (87%) accept Medicare,
significantly fewer of both (53% of internists) and (62% of family
physicians) accept MassHealth.
Even fewer accept Commonwealth Care (43% of internists; 56% of
family physicians) and Commonwealth Choice (35% of internists; 44%
of family physicians).
Similar differences were found for pediatrics: 89% accept
MassHealth, but only 50% accept Commonwealth Care and only 45%
accept Commonwealth Choice.
Specialty Care The overwhelming majority of
specialists accept Medicare and MassHealth, but significant gaps
exist between those plans and Commonwealth Care and Commonwealth
Choice.
Accepting Medicare are 96% of cardiologists, 97% of
gastroenterologists, 94% of obstetricians/gynecologists, and 98% of
orthopedic surgeons.
Accepting MassHealth are 92% of cardiologists, 85% of
gastroenterologists, 89% of obstetricians/gynecologists, and 82% of
orthopedic surgeons.
Accepting Commonwealth Care/Commonwealth Choice: cardiologists,
78%/76%; gastroenterologists, 68%/60%; obstetricians/gynecologists,
82%/71%; and orthopedic surgery, 59%/42%.
The survey was conducted between February 16 and March 8 of this
year, and included 838 telephone interviews. The complete study is
available at www.massmed.org/patientaccess
Practice Environment Continues to Decline
The Society also released its latest MMS Practice
Environment Index, a statistical compilation of nine factors that
influence the practice climate for physicians in the Commonwealth.
For 2010, the index declined 0.9 percent, representing a continued
deterioration of the practice environment for physicians in
Massachusetts. The index has declined in 17 of the 19 years the
Society has been compiling such data.
The index is available at www.massmed.org/mmsindex
The Massachusetts Medical Society, with nearly 23,000 physicians
and student members, is dedicated to educating and advocating for
the patients and physicians of Massachusetts. The Society publishes
the New England Journal of Medicine, a leading global medical
journal and web site, and Journal Watch alerts and newsletters
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. For more information please visit www.massmed.org, www.nejm.org, or www.jwatch.org.
Definitions of Insurance Plans:
Medicare is the U. S. government sponsored
health insurance program for people age 65 or older or under age 65
with certain disabilities. www.medicare.gov
MassHealth is a public health insurance program
for eligible low and medium-income residents of Massachusetts.
MassHealth is the name used in Massachusetts for Medicaid and the
Children's Health Insurance Program (CHIP), combined in one
program. www.massresources.org
Commonwealth Care is a health insurance program
for low and moderate-income Massachusetts adults 19 and older who
don't have health insurance and who are ineligible for Medicaid.
Members get free or low-cost health services through managed care
health plans. www.mahealthconnector.org
Commonwealth Choice is a health insurance
program for uninsured adult Massachusetts residents. The program
offers unsubsidized health insurance to people who are not eligible
for Medicaid or Commonwealth Care. www.mahealthconnector.org
