Contact: Richard P.
Gulla
rgulla@mms.org
781-434-7101
pager: 877-820-9023
A full copy of the MMS Index report
is available at www.massmed.org/mmsindex
Waltham, Mass. -- April 12, 2005 -- The Massachusetts Medical Society
(MMS) today released its Physician Practice Environment Index for
2004, and for medical doctors in the Commonwealth the news is still
negative. The analysis describes a practice environment for
physicians that continues to deteriorate and that has reached
another all-time low since the first year of measurement in
1992.
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The MMS Physician Practice Environment Index is a statistical
indicator of nine selected factors that shape the overall
environment in which physicians provide patient care in
Massachusetts. For 2004, six of the nine declined.
The Massachusetts index dropped 1.8 percent for 2004, the 11th
consecutive year that the index has fallen since 1993.
The US Physician Practice Environment, a companion index
compiled by the Medical Society that reflects the national practice
environment, also fell again, at a rate of 2.3 percent, for its
ninth consecutive drop. It was only the third time in 11 years that
the US index dropped faster than the state index.
"The bad news is that it just keeps dropping," said Alan C.
Woodward, M.D., president of the Massachusetts Medical Society, the
statewide association of physicians with more than 18,000 members.
"But the sad irony is that in a state known throughout the world
for its quality of medical care, physicians in Massachusetts
continue to work in a practice environment that's worse than the
rest of the nation."
Woodward said the declines in both the Mass. and US indices for
2004 were propelled by the same factor: sharp jumps in the cost of
professional liability insurance - the only double-digit jump on
both the state (11 percent) and national (16 percent) level of any
of the factors that comprise the index. Medical liability reform is
a top advocacy priority of the Medical Society.
While the last four years of consecutive double-digit jumps in
liability premiums have hit Massachusetts physicians hard,
ProMutual Group, the largest commercial insurer in the state, has
announced it will hold rates flat for 2005.
"That's welcome relief, although it's likely to be a one-year
phenomenon," said Woodward referring to ProMutual's
announcement. "And with the current projection of major cuts
in Medicare reimbursements for physician services of at least 5
percent per year over the next 5 years, the practice environment in
the state could deteriorate dramatically, since some other insurers
tie their reimbursements to Medicare."
The two other biggest factors dominating the Massachusetts index
for 2004 were (1) the ratio of housing costs to physician income;
and (2) the number of physicians 55 years of age and older.
The ratio of housing costs to physician income jumped 10 percent
last year, more than twice the rate of growth of physician income,
which rose just 4 percent. The number of physicians 55 years
of age or older rose 3 percent, continuing a decade-long trend of
the aging of the state's physician workforce - an indication of the
state's inability to retain and attract younger physicians.
The Physician Practice Environment Index findings on housing
costs echo two recent, separate reports from the Greater Boston
Chamber of Commerce and the Boston Foundation. Both reports
released last week said the region has some of the nation's highest
housing costs, threatening local economic health.
The Medical Society's annual Index and its Physician Workforce
Study consistently have found that high housing costs and soaring
liability insurance premiums have been some of the biggest
obstacles to recruitment and retention of physicians in the
state.
Woodward said low reimbursements for services, administrative
overload, and increasing costs of operating a practice are putting
additional pressure on physicians of all specialties across the
state. Citing several sources, the Medical Society has calculated
that the cost of operating a practice in the state, reflecting
costs of labor, rent, and medical supplies, has risen 63 percent in
Massachusetts since 1992, exceeding the national average by nearly
22 percent.
Economist James M. Howell, Ph.D., president of The Howell Group,
which developed the index with the Medical Society, stressed that
the rate of decline for Massachusetts continues to be much faster
than the country as whole. He said this relentless erosion in the
physician practice environment calls for action in three areas.
"The first step to improvement," said Howell, "is to resolve the
medical liability situation, which affects not only physician
practices but also patients and entire health care system. The
second step is to change the widespread reality and perception that
Massachusetts is not an attractive place to practice medicine. This
should lead to better recruitment and retention of physicians. And
the third step is to somehow address the high cost of doing
business in the state - another critical factor underlined by the
Chamber and Foundation studies.
"The biggest and most important step to take," said Howell, "is
the first. Fixing the medical liability situation will have a huge
impact on the other two areas. Only then will the practice
environment for physicians begin to improve."
The Massachusetts Medical Society developed the index to measure
the impact of nine indicators representing three major factors that
influence the practice environment for physicians:
- Supply of Physicians, including the number of
applications to Massachusetts medical schools, the percentage of
physicians over 55, and the number of employment ads in the New
England Journal of Medicine;
- Practice Financial Conditions, including New
England median physician income, ratio of housing prices to median
physician income, and professional liability costs;
- Physician Work Environment, including
physician cost of maintaining a practice, mean hours per week spent
in patient care, annual number of visits per emergency
department.
The Massachusetts Medical Society, with some 18,300
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, one of the
world's leading medical journals; the Journal Watch family of
professional newsletters covering 11 specialties; and AIDS Clinical
Care. The Society is also a leader in continuing medical education
for health care professionals throughout Massachusetts. Founded in
1781, MMS is the oldest continuously operating medical society in
the country.
