Physician Workforce Study

Will the Shortage of
Primary Care Physicians in Massachusetts
Derail Reform Efforts?
Bruce S. Auerbach, MD, FACEP
President
Massachusetts Medical Society
Enrollment through July 2008
120,000
110,740*
91,031
83,276
80,000
40,000
18,132
0
MassHealth
• May 1 data
•Source: Commonwealth Connector reports
<100%
101-300%
Commonwealth
Care
(30% pay monthly premium)
300+%
Commonwealth
Choice
But … Will They Have a Doctor?
Massachusetts Physician Workforce Study: 2007
Internal Medicine
Vascular Surgery
Family Practice
Neurosurgery
Anesthesiology
Cardiology
Gastroenterology
Psychiatry
Urology
Critical
Critical
Severe
Critical
Severe
Critical
Severe
Severe
Severe
But …When Will They See a Doctor?
Appointment Wait Times: 2007
122
106
76
75
66
52
54
36
29
34
21
8
Cardiology
46
23
8
GI
23
6
Internal
Medicine
Trend
Range and average for each specialty
OB/GYN
Orthopedic
Surgery
5
Family
Practice
N/A
Patients Feel the Strain
• Only 42% who made an appointment to see a
primary care physician could be seen within a
week
– Down from 53% in 2005 and 2006
• 21% were forced to wait for necessary medical
care
• The most commonly cited reason for delays
–
–
–
–
Overcrowded doctors’ offices (23%) up 13% from last year
Scheduling problems (16%)
A lack of insurance (12%)
The need to wait for a referral (10%)
Practices Accepting New Patients
79%
87%
87%
84%
OB/GYN
Orthopedic
Surgery
78%
51%
Cardiology
Trend
GI
Internal
Medicine
Family
Practice
N/A
Fixing the Supply Imbalance
• New incentive programs
– Loan forgiveness programs
– Partners Healthcare and community health centers
• State Health Care Workforce Center
• Advanced medical home pilots
– State program under Medicaid
– ACP pilot
– Mass. Blue Cross Blue Shield
• Expanded primary care training at UMass
Medical School
Other considerations
• Reducing administrative burdens
• Payment reform
• Patient engagement
– Wellness programs
– Chronic disease management
– Lifestyle changes
• Care must be comprehensive and
integrated