BY JEFFREY PERKINS, JD, MMS LEGISLATIVE & REGULATORY AFFAIRS COUNSEL
Illstration by Sioux Waks
Last year, the Medical Society released the “Supporting MMS Physicians’ Well-Being Report: Recommendations to Address the Ongoing Crisis.”
The report, leveraging data from an MMS member survey, sheds light on the continuing crisis in physician well-being and workforce instability and drew national headlines for revealing that 55 percent of respondents experienced symptoms of burnout,
and 50 percent said they had already reduced their clinical hours or were planning to as a result. The data further highlighted the need for more attention to the occupational well-being of particular groups of physicians, including women, physicians
of color, those from backgrounds underrepresented in medicine, and younger physicians. In addition to identifying specific stressors physicians were experiencing, the report recommended actions to address physician stressors while improving and
increasing support for physicians in the workplace.
You told us what you’re experiencing, so what comes next?
The survey data and the recommendations contained within the report have informed the work of the Medical Society over the past year and will continue to do so moving forward. What does that mean on a practical level? Here is some of what the Medical
Society is doing to put the report’s recommendations into action.
“Physicians and patients need representation to speak out so that the health plans and the legislators hear our concerns and so they can act to alleviate the pain,” says MMS President Barbara S. Spivak, MD. “The MMS can and has made a difference,
and we will continue to do so.”
To address workforce and staffing issues, physicians — who play such a critical role in the health care system — must be a primary focus of health care workforce solutions. To that end, the MMS in October 2023 hosted and facilitated
a listening session with physician leaders and leaders from the state Health Policy Commission (HPC) on the state of the physician workforce, which identified the serious workforce challenges and engendered constructive dialogue centered on actionable
solutions. This session was held to inform the HPC’s research on needs within primary care broadly, but also to explore challenges and solutions regarding the entire physician workforce. The MMS will continue to support the HPC’s research efforts,
culminating in a comprehensive physician workforce report that is expected later this year.
Supporting the financial viability of physician practices is vital to reducing physician stress and maintaining and expanding access to health care in the Commonwealth. After much MMS advocacy around the dire state of primary care,
MassHealth increased investment in primary care practices that participate in the ACO Primary Care Sub-Capitation Program, in the form of significant rate increases for participating practices that are wholly independent. Sub-capitation rates
are increasing by 25 percent for adults and 35 percent for children for 2024 contracts, collectively impacting approximately 85 percent of participating ACO provider organizations. We continue to work with the Healey administration to build on
this investment to meaningfully support physician practices as outlined in the Medical Society’s letter to Kate Walsh, Secretary of Health and Human Services.
On the federal level, the MMS and other medical societies have advocated to Congress to cancel the 3.37 percent pay cut in the Medicare physician fee schedule, which in early March was reduced to a 1.68 percent cut for the remainder of 2024. For
the longer term, we continue our efforts toward meaningful reform to the Medicare payment system that will provide physician practices with greater predictability, stability, and sustainability. These changes are intended to ensure that our nation’s
most vulnerable patients have reliable and continuous access to their physicians.
Removing excessive administrative hassles has been a longstanding priority for the MMS’s advocacy agenda, with a significant focus on prior authorization reform. The MMS spearheaded prior authorization legislation that is now on the move. This bill aims to increase transparency and consistency in the process, reduce administrative burden, and limit the number and types of services for which prior authorizations are required. The advancement of this legislation,
following a favorable report from the Financial Services Committee, represents an important step toward reducing the physician’s administrative burden and ensuring timely patient access to high-quality, efficient care.
Support for physician health and well-being is critical for physicians and their patients. Massachusetts is one of the first states to remove barriers for physicians seeking mental health and addiction treatment. This significant
effort was widely reported by both local and national media and applauded by organizations such as the Dr. Lorna Breen Heroes’ Foundation.
As part of the health care community’s broader strategy to support clinician well-being and reduce stigma within the ranks of the profession, Massachusetts physicians, hospitals, health systems, and local health plans joined forces to commit to eliminating
potentially stigmatizing or overly broad invasive questions from their credentialing processes. Following extensive review, coalition building, and advocacy from members of the Mass Collaborative, the
National Committee for Quality Assurance will no longer require that health plans ask clinicians about their prior drug use. This enabled the Collaborative to update the Integrated Massachusetts Application
for Initial Credentialing form used by health plans and many hospitals. This change comes after similar amendments made by BORIM to questions regarding prior drug use and mental health on the physician license application, which was also a result
of significant advocacy by the MMS and our partners. This is welcome news to physicians, residents, and students alike.
Sexism and racism as workplace stressors. The survey results revealed that racial inequities and structural racism were large contributors to the stressors leading to physician burnout. Seeking actionable solutions to these issues,
the MMS hosted a virtual roundtable discussion about the importance of and steps toward improving diversity in the physician workforce. The goals of this conversation were to determine best practices for improving workforce diversity and to develop
an action plan for strengthening the physician workforce through various, coordinated approaches at all stages of medical careers. The attendees, who represent health care stakeholders from across the state, examined the status and impact of workforce
diversity and health care disparities here. Attendees discussed the importance of formulating public diversity, equity, and inclusion (DEI) progress reports, growing mentorship programs, and expanding recognition awards. Many commented on the
need to tailor DEI approaches to the needs of target populations rather than have one plan for all marginalized and minoritized demographics.
The survey results contained within the physician well-being report are sobering, but they also provide a valuable guide to addressing the challenges affecting physicians’ ability to deliver quality care and enjoy the profession of medicine. The MMS
remains committed to supporting you, our members and all physicians, and focusing efforts on the actions and issues that will help improve your practice of medicine and satisfaction in this most important of professions.
