WBUR

Mass. Doctors Not Seeing New Patients, Wait Times Lengthening

BOSTON — If you thought the wait time to see a doctor was getting longer, you’re right. The latest survey from the Massachusetts Medical Society shows that finding an appointment in six of seven specialties is either harder this year or no better than last.

If you’re a new patient and want to see a family physician, about half of all practices aren’t taking anyone new. If you have a public insurance plan, such as Medicare and Medicaid, then you may have some additional trouble receiving care.

The report has serious implications for health care costs in the state, the doctors group said, because patients unable to see a primary care physician are likely to seek more expensive emergency room treatment.

“Massachusetts has made great strides in securing insurance coverage for its citizens,” said the MMA’s president, Dr. Alice Coombs, referring to the state’s landmark 2006 universal health insurance law. “But insurance coverage doesn’t equal access to care.”

The telephone survey of 838 doctors conducted in February and March found that 51 percent of internists are not accepting new patients, up from 49 percent the previous year. Fifty-three percent of family physicians, the other major group of primary care doctors, were also not taking new patients.

Even for patients fortunate enough to have a primary care doctor, waits for appointments continued to be lengthy. The average wait for an appointment with an internist was 48 days, which was five days shorter than last year, but the average wait for family medicine was 36 days, a week longer than in the 2010 survey.

Patients were also waiting longer to see specialists. The average wait for gastroenterologists, obstetricians/gynecologists, orthopedic surgeons and cardiologists were all higher than a year ago, the report said.

An ongoing shortage of new primary care physicians entering the system was cited as the principal reason for why so many existing ones had simply stopped accepting new patients.

“There’s only so many patients you can see in a day,” said Dr. Lynda Young, a Worcester doctor and president-elect of the MMA.

Medical students are eschewing the grueling hours and lower pay that primary care often entails in favor of specialties that offered a more consistent work schedule and quicker path to repay medical school debt, experts say.

The problem can be particularly acute in rural areas.

Dr. Joseph Viadero, of Connecticut River Internists, said the four doctors and three nurse practitioners who staff the practice in Turner Falls, Mass., have about 12,000 patients spread between them and cannot take any new ones.

“We’re overwhelmed and just have difficulty taking care of our own patients,” Viadero said, who has struggled to recruit any new primary care physicians to serve in the small western Massachusetts community.

The consequences are more people going without preventative health care and turning to hospital emergency rooms when they’re sick, he said.

Specialty care also can be difficult to find in the area, with Viadero often forced to send patients to Springfield, 35 to 40 minutes away, to see specialists.

Dr. Richard Dupee, a primary care physician in the Boston suburb of Wellesley, continues to accept new patients, though he already has some 8,000 in his practice. He said he’s willing to put in the long hours necessary to keep up, but many younger doctors take a different approach.

“They really look upon lifestyle more importantly than income,” Dupee said. “They want to quit at 5 o’clock is the bottom line.”

Amy Whitcomb Slemmer, executive director of the advocacy group Health Care for All, said doctors have so many patients they often reduce appointments to just 15 minutes, which she calls “untenable” for patients.

“We have to provide incentives and benefits to doctors to go into primary care medicine,” she said.

The study also found that while the vast majority of primary care physicians in Massachusetts accepted Medicare, only 53 percent of internists and 62 percent of family physicians accepted MassHealth, the state’s Medicaid plan.

Only 43 percent of internists and 56 percent of family physicians accepted Commonwealth Care, the state-administered program that provides subsidized care for those earning up to three times the federal poverty level.

The release of the report Monday comes on the MMA’s annual “Doctors Day,” in which hundreds of physicians come to the State House to lobby legislators.

The Associated Press and WBUR’s Martha Bebinger contributed to this report.

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  • http://www.facebook.com/nicmart Nicolas Martin

    Welcome to the world of RomneyCare and ObamaCare. Soon the whole country will suffer from the disease of socialized healthcare.

    • fred

      If we reduce the number of people who have access to food and shelter that might be more convenient for you, also. Of course you might have to spend a little on walls and barbed wire and a night watchman to keep the great unwashed from helping themselves to your larder.

      • http://www.facebook.com/nicmart Nicolas Martin

         How often do the poor help themselves to your larder? Do you leave the door unlocked. Do you invite the poor to take what they wish? I smell hypocrisy.

    • Kayu

      You don’t get it do you Nicolas? ObamaCare is the only “reform” that the Medical Industrial Complex will allow. It is a “reform” that will save the current system and will ensure that the 18% of our GDP that is devoted to healthcare will soon be 21% then 25% … a percentage that in countries that have single payer systems remains in the single figures …

      • Dornjim

        So you drank the koolaid, They didn’t even include the Billions required to the Dr fix of medicare. Get the Facts or be a lackey.

  • http://profiles.google.com/drphilxr Phil Kousoubris

    Nothing new. Universal coverage does not = better access. Maybe the problem isn’t the doctor, or the patient….

  • Anonymous

    I expected the comments below that point to “socialized health care” as the culprit in the mess we call health care in the country. If National Health Care systems were so bad then how do you folks explain the France is #1 in the world in health care and we rated are 37 by the World Health Organization.

    You get better health care in Costa Rica for Pete’s sake! So here’s my comment for your folks,

    The health care bill in this state did nothing to help with the problems of health care other than some subsidies for people who can’t afford it. Those are going away as fast as people with allergies sneeze on a high pollen day. It mandates everyone have it which is just kicking the can down the road. Premiums are up about 20% this year and in some cases more. We have dysfunctional health care system that is broken.

    It seems to me as a nation we are not able to solve this problem. Is it because we are a nation of selfish rubes who only care about our own self interest? I hope this is not the case. I hope we can rise above the partisan nature of this and do what is right. Create a fair and well funded health care system based on health care and not the market.

    1 France2 Italy3 San Marino4 Andorra5 Malta6 Singapore7 Spain8 Oman9 Austria10 Japan11 Norway12 Portugal13 Monaco14 Greece15 Iceland16 Luxembourg17 Netherlands18 United Kingdom19 Ireland20 Switzerland21 Belgium22 Colombia23 Sweden24 Cyprus25 Germany26 Saudi Arabia27 United Arab Emirates28 Israel29 Morocco30 Canada31 Finland32 Australia33 Chile34 Denmark35 Dominica36 Costa Rica37 United States

    • Dornjim

      Your research fails to compare apples to apples.
      The World Health Organization (WHO), under the umbrella of the gutless United Nations League, ranked America 37th out of 191 nations. What you are not hearing is what the standards are and what the focus areas are for theses rankings. The main areas are support for government health programs, government development of health policies, efforts related to determinants of health, such as food safety and nutrition. IN OTHER WORDS EACH COUNTRY IS RANK ON HOW MUCH THE GOVERNMENT PROVIDES FOR THE COUNTRY OR HOW SOCIALIZED MEDICAL CARE IS IN EACH COUNTRY. The World Health Organization primarily faults the United States for not requiring mandatory insurance or offering social welfare programs to all citizens–in other words, for being a free country with independent citizens. So, America does not rank well because it is not Socialized Health Care.The other thing you are not hearing is one very under publicized category that president Obama will not tell you in his “Town Hall Meetings , and other Liberals fail to broadcast that America’s health system ranked first in responsiveness to patients’ needs for choice of provider, dignity, autonomy, timely care, and confidentiality. In other words, where it matters most to patients, the U.S. system excels. Guess who done poorly on this category, YEP you guessed it, France and Canada.So who is really number one?

      • Anonymous

        “and other Liberals fail to broadcast that America’s health system
        ranked first in responsiveness to patients’ needs for choice of
        provider, dignity, autonomy, timely care, and confidentiality.”

        Your response is amazing in it lacks any of the things that health care is supposed to do.

        Let’s unpack your main talking points. I’ll ignore the anti WHO rant.

        First point:The US ranked first in choice of provider?

        Not unless they are approved by your insurance company. The other thing is most doctors are so overwhelmed with all the paperwork for the insurance companies that they have less time to see patients or to deliver good GP care.

        Dignity? Well I’m not sure how this works if you lose your hose do to health care costs.

        There is no dignity in filing for bankruptcy. Medical bills are the major cause of bankruptcy in our country. My ex’s late mother died with dignity at her home with a nurse at her side. She lived in Scotland and all of this was paid for by the NH system.

        Autonomy? You’re kidding right? This is what makes our system better than the French and Canadian systems? I know people in Canada and they have nothing but glowing praise for their system. It’s not perfect, but it’s better than ours by miles.

        Timely care? This is a joke. I know of countless people who have to wait for weeks and sometimes months to see a specialist. If you can afford to pay for special treatment I guess you can cut ahead.

        Confidentiality, then how do you explain insurance companies using preexisting conditions to deny people care?

        How anyone can defend our dysfunctional market based system is beyond me.

        I will say this, your comment is full of patriotic fluff and partisan nonsense.

        Health care is not about political parties, it’s about the dignity and having a system based on compassion and dignity.
        Not on how wealthy you are.

      • Anonymous

        I live between France and the United States. France does not have a socialized health care, it is a mix of public and private funding with a government regulated structure of fees and costs, though private practices can charge more for whoever can afford it.

        The US system is way below the standard of the French one. If for any particular reason I’m out of my network (travel) in the US, I need to go to an ER, in France you can call a doctor in the middle of night that will come to your home!…. at a fraction of the cost of an ER visit. You can visit a specialist without a physician’s referral, a huge saving in cost.

        France has over 50 years of experience in universal health care, starting way back when health care did not cost a lot, they build a unique experience mixing public, private, for profit and non-profit organizations, and that is the main difference.

        Take the reimbursement system for example, doctors in France do not need to process insurance claims (except hospitals), patients pay doctors and send the claim form to their insurance. As a result, doctors do not need to employ staff for processing claims and their fees are lower. Liability claims caps also play a role in lower fees and costs.

        Does it cost? Yes. France runs a $6B deficit every year, but that is only $100 per inhabitant, when you consider that they don’t even have co-pays, $100 is nothing in compare to the out of pocket expenses every American incur every year.

        Stop bashing the French and the WHO ranking but take example instead. America live in its own bubble, and it’s bursting.

  • Linnie

    doctors don’t accept MassHealth because payments are too low. Unless something has changed, anybody who shows up in the Mass system gets one year free mass health – no verification required — also, I don’t have a problem with waiting for an appointment with a doctor, in an emergency my doctor’s clinic will work one in (I think they set aside time for each day for these kinds of issues) – otherwise, so what if you have to wait a couple of months for routine visit? as for specialists, I suspect referrals are made because of how insurance companies pay out, for each service rather than the total care package – Everytime I read whines about how other countries make people wait, and specialists are impossible to see, I think are we as a country that stupid that we think we must have our every perceived need gratified instantly?

    • Anonymous

      We have fee for service system. Let be honest here, our fee based for profit system is broken.

      I have lived in Great Britain and used the NH system and as far as I can tell in my experience it’s no better or worse than ours except I wont lose my house if I get sick. My ex’s late mother had two liver transplants in Scotland (rare liver disease) she only had to wait for a a match. If she was in this country she would have died over 20 years ago as she would not have been able get affordable health insurance due to her preexisting condition. Our market based system is broken.

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  • Bob

    VOTE OBAMA 2012 if you want to move the usa to once again having the best healthcare in the world

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