State medical society reports improvements in access to care

Wait times continue to be long in primary care offices in Massachusetts, but more doctors are accepting new patients, a report shows.

By — Posted Aug. 24, 2012

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In Massachusetts, it may be more challenging to get care from a primary care physician than a specialist.

Health care access in the state is improving, but about half of internists and family physicians still are not accepting new patients, according to a study released Aug. 8 by the Massachusetts Medical Society (link).

In 2012, 50% of family physicians said they were taking new patients, a slight increase from 47% in 2011 and 46% in 2010. Acceptance of new patients among internists was 51% in 2012, compared with 49% in 2011.

Four surveyed specialties reported much higher acceptance rates of new patients: 84% for cardiologists; 86% for obstetricians-gynecologists; 92% for gastroenterologists; and 98% for orthopedic surgeons.

The medical society’s study examined physician acceptance of new patients and Medicare and Medicaid coverage, as well as wait times for new patient appointments. The results were based on 830 telephone interviews with physician offices representing seven specialties conducted earlier in 2012. The report also queried patients on how satisfied they were with their health care.

Patients in Massachusetts who schedule first-time appointments may have to wait longer to see a primary care doctor than a specialist. Wait times for new patient appointments with a family physician increased from 29 days in 2010 to 45 days in 2012. The medical society said the state’s shortage of family physicians, as well as fewer students and residents taking up family medicine, could be contributing to longer wait times.

Gastroenterologists had a 44-day wait in 2012, the same as internists. Other specialties reported shorter wait times than primary care. Orthopedic surgeons, for example, had a 16-day wait time for new appointments, down from 26 days in 2011. Wait times for pediatricians averaged 23 days.

Doctors in the state have been more reluctant to accept Medicaid as a payer than Medicare. Primary care had the lowest acceptance rates of Medicare and Medicaid. The medical society said there were decreases in Medicaid acceptance in 2012 among orthopedic surgeons, cardiologists, pediatricians and ob-gyns.

Danny McCormick, MD, MPH, an assistant professor at Harvard Medical School in Boston, said the medical society’s findings on Medicaid were consistent with his research. His study, published online July 24 in the Journal of General Internal Medicine, found more cost-related access problems among those getting care through subsidized programs such as Medicaid and Commonwealth Care than those with private insurance (link).

Low payment rates for public insurance is the likely reason why patients in these programs are facing access challenges, he said. “This is a long-standing story with Medicaid in Massachusetts and the rest of the country that has been described in other reports.”

Despite continuing access issues with primary care, the Massachusetts survey of more than 400 adults revealed that most were satisfied with their health care. Ninety percent said they saw a primary care doctor in the last year, and nearly 80% said they had no difficulties in getting needed care. The research overall shows “an improving picture of access to and satisfaction with health care” in Massachusetts, according to a statement by Richard Aghababian, MD, the medical society’s president.

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