Primary care shortage 'critical,' physician survey says

Internal medicine and family practice physicians are in critically short supply in Massachusetts, according to a poll of doctors in the state.

The Massachusetts Medical Society today reports in its seventh annual Physician Workforce Survey that the two primary care specialties join 10 other types of medical practice that are experiencing shortages. Oncologists, neurologists, and dermatologists are also on the list of doctors in high demand. The other seven specialties are anesthesiology, emergency medicine, general surgery, neurosurgery, psychiatry, urology, and vascular surgery.

The survey asked doctors, hospital heads, and leaders of medical education about how long it took patients to get a doctor's appointment, or be referred to a specialist. It also asked about recruiting and retaining physicians, and keeping newly trained doctors in Massachusetts.

The primary care shortage is not a surprise, given nationwide trends and additional pressures in Massachusetts from patients newly insured under the state's near-universal coverage mandate. Wait times for new patients changed slightly from last year: down to 50 days (from 52) to get an internal medicine appointment and up to 36 days (from 34) to see a family medicine doctor. A survey of physician offices found that 42 percent of internal medicine and 35 percent of family medicine practices were closed to new patients.

"Universal coverage does not equal universal access," society president Dr. Bruce Auerbach said in a statement released with the report. "With more patients, an aging population, and rising rates of obesity and chronic disease, demand is overwhelming supply, and our physician workforce is coming under more stress and strain."

Almost half of the doctors surveyed said they are dissatisfied with the practice environment in the state. Other medical society surveys have named the cost of doing business, including liability insurance, and high housing prices, as factors affecting recruitment and retention of doctors.

Improving technological support, reducing administrative burdens, and reducing medical school debt were proposed as ways to help physicians stay in the profession and in Massachusetts. Residency program directors said 52 percent of medical residents leave Massachusetts. For those who stay, the most attractive aspects of a medical career in Massachusetts are the intellectual and research opportunities here, they said.