Massachusetts continues to face a shortage of doctors in key specialties while struggling to recruit and retain enough physicians to work at community hospitals and in areas of the state outside of Boston, according to a report released Tuesday.
At the same time, more doctors say they're willing to participate in the state's push to overhaul the health care payment system, including planned initiatives like accountable care organizations and global payments.
The findings are included in an annual report by the Massachusetts Medical Society that looks at the status of the physician workforce in the state. The report also found a small decline in the number of physicians who reported that they've altered or limited their practice for fear of being sued.
"This year's study has mixed results," said the society's president, Dr. Richard Aghababian.
The study — based on surveys of practicing physicians, department chiefs of teaching hospitals, and medical staff presidents of community hospitals — found seven of 18 specialties to be in critical or severe shortages. That's one fewer than in 2011.
Shortages in internal medicine, psychiatry, urology and neurosurgery met the study's criteria of "critical." Three other specialties were classified as "severe"- family medicine, dermatology and general surgery.
The medical society also found what it called "mixed results regarding the recruitment and retention of physicians in the state."
The study said more than 94 percent of community hospitals reported significant difficulty in filling vacancies. That's compared with about 7 percent of the state's teaching hospitals reporting similar difficulties.
Officials at community hospitals said the biggest hurdle in filling positions is a reluctance on the part of doctors to work at small hospitals given the high cost of living in Massachusetts and the lower salaries paid at community hospitals.
The study also found that in the four labor markets of Worcester, Springfield, New Bedford-Barnstable and Pittsfield-Western Massachusetts, it was harder to fill vacancies than in Boston.
And it found that nearly half of doctors said they were willing to participate in a voluntary global payment system while two-thirds said they were likely to participate in voluntary accountable care organizations.
Global payment systems and accountable care organizations are designed to help reward doctors and hospitals for maintaining the health of patients and to move the state away from a more traditional "fee for service" model of care.
Both are part of a massive health care overhaul bill approved by lawmakers and signed by Gov. Deval Patrick earlier this year.
Backers of the bill say it will save up to $200 billion in health care costs over the next 15 years and is critical to the long-term financial success of the state's landmark 2006 health care law.
Aghababian said that while many doctors are open to the changes approved in the new law, many are still waiting to see how it will play out.
"Just how the law will affect our physician workforce and to what degree is unknown at this time," Aghababian said in a statement accompanying the report. "It is something we will be watching carefully, particularly as it affects physician practices and patient care."
This program aired on October 2, 2012. The audio for this program is not available.