i cannot find the exact article where mgh was refusing patients for primary care. Article was saying new patients would be directed to local areas for care.
here is a survey done about a year ago on staffing of doctors in massachusettes. Now with obama health care program passed and current difficulties with ma health program it will be interesting to see the next update this june.
Primary Care: Long waits, more practices are closed to new patients
The primary care specialties of internal medicine and family medicine have been under intense pressure with the addition of some 440,000 newly insured residents as a result of the state’s health care reform law. That pressure continues, as the 2009 study marks the fourth consecutive year that both of these specialties have been found to be in short supply.
More practices closed to new patients: More primary care physicians have closed their practices to new patients, continuing a trend from prior years. The telephone survey of physician practices showed that the percentage of family medicine physicians who are no longer accepting new patients has increased over the past three years from 30% in 2007 to 40% in 2009. The percentage of internal medicine physicians no longer accepting new patients has also increased, from 49% in 2007 to 56% in 2009. These are the highest percentages of primary care practices closed to new patients the Medical Society has ever recorded in its Physician Workforce Studies.
Wait times: Long wait times for appointments for new patients continue to be a problem, resulting in delayed access and care. For internal medicine, the average wait time is 44 days, six days shorter that last year’s figure of 50 days. For family medicine, the average wait time is 44 days, eight days longer than last year’s figure of 36 days.
Community hospital shortages: The Medical Society's study also found that primary care physicians are some of the most critical scarcities facing community hospitals: 75% of community hospitals reported shortages in internal medicine, and 58% reported shortages in family medicine. Both are substantial increases (19% greater for internal medicine; 14% greater for family medicine) over the 2008 study.
Specialty care: Continuing Strain, Difficulty with Referrals
A large majority of physicians – 69% -- reported difficulty in referring patients to a specialist, a recurring problem from previous years. The difficulty is especially acute with the primary care specialties: 85% of family medicine and 77% of internal medicine report difficulty in referrals to specialists.
Recruitment and Retention: Especially Hard for Community Hospitals
A recurring theme throughout all eight years of the Society's studies is increasing difficulty in recruitment and retention of physicians, and both continue to be major problems in overcoming physician shortages. The situation is especially acute with community hospitals.
Inadequate pool for recruitment: The supply of available physicians is weak, with 96% of community hospitals, 74% of practicing physicians, and 46% of teaching hospitals saying the pool available to recruit physicians is inadequate.
Retention: Keeping existing staff has become more difficult for 26% of teaching hospitals, 35% of practicing physicians, and 61% of community hospitals.
Recruitment: Hiring has become more difficult, with 91% of community hospitals, 54% of practicing physicians, and 36% of teaching hospitals experiencing difficulties in filling physician vacancies.
Time to recruit: Difficulty in recruiting is reflected in the time it takes to recruit physicians. The survey of practicing physicians indicated that the time to recruitment has increased over the last three years, with 13 specialties averaging more than one year for recruitment: dermatology, 28.6 months; neurosurgery, 24.8; neurology, 19.2; urology, 16.7; family medicine, 15.5; orthopedics, 17.6; gastroenterology, 16.8; obstetrics/gynecology, 14.9; oncology, 14.5; internal medicine, 13.8; cardiology, 13.5; general surgery, 13.5; and vascular surgery, 12.5.
Job Vacancy Rates The job vacancy rates for physicians in teaching hospitals in 2008 was 4.6%, nearly two and half times the rate for all occupations in the state. The specialties with the highest job vacancies rates were vascular surgery (16.4%), dermatology (16.3%), family medicine (14%), oncology (12.3%), neurosurgery (10%), urology (9.3%), pediatrics (9%), and gastroenterology (6%).
Professional Liability: A Big Negative Influence on the Practice of Medicine
The 2009 study again found that professional liability (medical malpractice concerns) and the fear of being sued continue to have a substantial negative influence on physicians and the practice of medicine. This finding is consistent with the Society’s previous Workforce Studies and its first-of-a-kind Investigation of Defensive Medicine in Massachusetts, released in November of 2008, which showed that the fear of being sued is a serious burden on health care. Findings from the 2009 Workforce Study:
46% of physicians surveyed said their practice is being altered or limited because of the fear of being sued, an increase of 2% from the year before.
More than half of physicians in nine specialties, two more than last year, said they have altered or limited their practice because of the fear of being sued: orthopedics (71%), urology (64%), neurosurgery (62%), gastroenterology (62%), obstetrics-gynecology (60%), emergency medicine (59%), cardiology (53%), family medicine (51%), and internal medicine (51%).
21% of physicians reported that professional liability fees were more than 15% of their total operating costs. The top specialties reporting these high ratios for liability fees in 2009 were obstetrics/gynecology (77%), general surgery (59%), neurosurgery (57%), and emergency medicine (40%).
Regional findings across the state show recruitment remains difficult
The 2009 study examined physician workforce issues across four regions in Massachusetts: Boston metropolitan area, New Bedford/Fall River/Barnstable County (Cape Cod), Springfield, and Worcester for all physicians and primary care specialties. (A limited sample response from primary care physicians in the Pittsfield/Berkshire County area, normally included in the annual study, precluded an analysis of that region for this year’s report.)
A key finding from the regional data is that recruitment of physicians remains difficult. The percentages of practicing physicians reporting difficulty in filling vacancies were 65% in Boston; 68% in Worcester; 71% in Springfield; 76% in Bedford/Fall River/Barnstable County.
massmed.org |
