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Report Highlights Challenges In Obtaining Healthcare In Commonwealth

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The Massachusetts Medical Society has released an annual study revealing that patients in the western part of the Bay State are still facing challenges in accessing healthcare.

This week, the Massachusetts Medical Society released its ninth annual Patient Access to Care Study, which surveyed 1,137 physician offices across the state in fields ranging from family and internal medicine, to specialties including OB/GYN, cardiology, gastroenterology, orthopedic surgery, and pediatrics.

The study focused on wait times for new patients seeking non-emergency appointments with physicians, the percentage of physicians accepting new patients, and physician acceptance of government health insurance programs including MassHealth and Medicare.

And some problems remain for patients in Western Massachusetts. According to the survey, the average wait time to obtain an appointment with a family physician is 102 days. In Franklin County, the average is 106 days. The average time to see a family physician across the state is 39 days.

Speaking for Berkshire County, Dr. Basil Michaels, a practicing plastic surgeon and President of the Berkshire District of the Massachusetts Medical Society, said that the average wait time for an appointment with an internist is more than 60 days shorter than a family physician – something unusual compared to the rest of the state. Dr. Michaels said that that has to do with the high percentage of patients in the Berkshires enrolled in MassHealth.

"With the family practitioners, 90 percent of them accept MassHealth, whereas with internal medicine only 58 percent accept MassHealth. And so that additional patient burden is directly responsible for the longer wait times, but also it means that they have to wait because they can't get their care anywhere else," said Dr. Michaels.

Dr. Michaels said that certain factors including rural poverty and an aging population, account for the increased reliance on government run healthcare in the Berkshires. Medicare and MassHealth provide typically lower reimbursements when compared with traditional private health insurance, making it more difficult for doctors and hospitals to provide quality care.

"The high rate of retired people that are on Medicare, and we have a 30 percent penetrance, which is unusually high for the state and for the country, and the socio-economic status of people that unfortunately forced them into MassHealth insurance that makes for more difficult hurdles to overcome," said Dr. Michaels.

According to the report, only 51 percent of family physicians are accepting new patients. Dr. Ronald Dunlap, President of the Massachusetts Medical Society, said that beyond reimbursement, an aging physician workforce also plays a role.

"A lot of the docs who are in private practice who still make up a significant part of the workforce are older. They have established panels of patients so many times they're not taking new patients, and a lot of it is just supply-and-demand," said Dr. Dunlap. "Now that more people have coverage there are obviously more people seeking a primary care provider but the interesting thing is that is clearly not just an economic problem."

Over the past 7 years, acceptance of new patients for primary care has dropped 19 percent, for internal medicine over the past 9 years, 21 percent.

But the report shows that access to specialists is improving, with 85 percent of cardiologists, 92 percent of gastroenterologists, 84 percent of OB/GYNs and 98% of orthopedic surgeons accepting new patients.

However, community hospitals in western Massachusetts have also faced challenges in retaining staff including surgeons. Dr. Michaels said that smaller hospitals with lower patient volume face increased pressure on surgeons.

"Pay is obviously a huge reason but in a field like neurosurgery...well you have to take care of patients 24 hours a day. And if there's only two of you that means that you are on call every other day, meaning that you could be working 36 hours on, and 12 hours off." 

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Lucas Willard is a reporter and host at WAMC Northeast Public Radio, which he joined in 2011.
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