slides: Central Massachusetts Doctors Fear The Future
Wednesday, September 18, 2013
The 2013 MMS Physician Workforce Study, a statewide survey of physicians, reveals that more than half of doctors surveyed in the Worcester regional labor market describe an inadequate pool of physicians that requires an increased time to recruit.
The pessimism of Worcester-area doctors is even more severe than the statewide averages, which also show the 8th consecutive year of shortages of primary care physicians.
A state "under stress"
“The supply of physicians in the state remains under stress, notably with primary care,” said Massachusetts Medical Society President Ronald Dunlap, MD, “and recruitment and retention continue to be difficult, especially for less populated areas of the state. Those factors affect patient access to care.”
"It's a disheartening study, because in so many ways, Massachusetts is such a cutting-edge place of healthcare," said Michael Hirsh, MD, President, Worcester Dictrict Medical Society. "We're in the forefront of the affordable care revolution, we've been an important innovator in medical education and in the training of residents. We are blessed with four fantastic medical schools and we have an incredibly intelligent patient population relative to other communities around the country."
In many ways in Massachusetts, Hirsh said, "we have the elements to make an ideal, almost utopian healthcare system. But it's not turning out that way."
Among the state's five regional labor markets (Boston/Greater Boston, New Bedford/Barnstable, Springfield, Pittsfield/Western Massachusetts and Worcester), the report reveals stark differences in recruitment and retention--Worcester being among the markets with serious recruitment and retention issues.
With the Boston/Greater Boston market as a baseline for comparison, the study shows that it is three times as difficult to fill physician vacancies in the Pittsfield/Western Massachusetts market, twice as difficult in the Springfield market, and more than one-and-a-half times as difficult for the Worcester and New Bedford/Barnstable regions than it is for the Boston/Greater Boston region.
In every region of the state, 50% or more of the physicians said the pool of physicians from which to recruit was inadequate.
For more key findings from the study, see the slides, below.
Worcester's challenges in recruiting, retaining
The Worcester market was judged third most difficult for recruitment and retention, with 57% of physicians reporting an inadequate pool of physicians, 43% reporting it was more difficult to retain staff, 30% saying it was significantly difficult to fill vacancies, 39% reporting the need to alter services, and 49% reporting the need to adjust staffing.
Hirsh sees statewide patterns having a more pronounced effect in Worcester. "We have a somewhat sparser entity of population than eastern Massachusetts and a more pronounced dearth of primary care physicians," he said. "Even though we have a fantastic medical school and great internal medicine program at St. Vincent Hospital, we don't retain a lot of them. The practice environment [here] is not as conducive as it should be."
Most and least optimistic markets in Massachusetts
The most optimistic numbers came, as may be expected from the Boston/Greater Boston market. Physicians here reported the fewest challenges of the five labor markets in physician recruitment and retention. Only 18% reported difficulty in filling vacancies, and less than one–third saw the need to alter services (27%) or adjust staffing (30%). Still, nearly one-third (32%) said it was more difficult to retain staff and one-half (50%) said the pool of physicians for hiring was inadequate.
Pittsfield/Western Massachusetts reported the bleakest outlook. Physicians in this market reported more difficulty than the other regions in four of the six categories examined. Nearly eight in ten physicians (78%) said the pool of physicians from which to recruit was inadequate, 47% reported it is more difficult to retain staff, 43% said it was difficult to fill vacancies, 63% reported the need to adjust staffing, and 57% reported the need to alter services.
The MMS 2013 Study
The 2013 Study is the Society’s 12th annual comprehensive look at the physician workforce in Massachusetts and is based on a survey of practicing physicians across the state. Among the topics examined are the supply of physicians; recruitment and retention; satisfaction with the profession and practice environment; familiarity with health reform efforts; the impact of professional liability concerns on the practice of medicine; and knowledge of and willingness to participate in global payment programs and accountable care organizations. The study also included a smaller survey of medical residents and fellows and their willingness to practice in Massachusetts after completion of training.
MMS President Dunlap said the 2013 study revealed continuing difficulties as well as improvements within the physician labor force.
On the plus side, Dunlap said, physician satisfaction with the profession remains high. "More physicians are becoming familiar with reform initiatives, such as global payments and accountable care organizations, and more physicians indicated they are likely to move to global payments to reduce health care costs," he said.
For more about statewide physician workplace results and trends for 2013, see the slides, below.
The Massachusetts Medical Society’s 2013 Physician Workforce Study was conducted in collaboration with economist James Howell, Ph.D., of The Howell Group. The complete report is available at http://www.massmed.org/workforce.
Satisfaction with MA
Less than half (43%) of physicians expressed satisfaction with the practice environment in the state, with 39% saying they are dissatisfied. MMS officials say that the fact that less than half of all physicians are satisfied with the practice environment reflects the findings of the annual MMS Physician Practice Environment Index, a statistical compilation of nine selected factors that influence the overall practice climate for physicians in the state. While the index rose slightly (up 0.6%) in 2013, it has declined by more than 25% since its peak in 1993.
Care vs. administration
More than half (53%) of physicians are dissatisfied with the division between patient care and administrative tasks. This percentage has remained constant over the last three years and is especially pronounced among primary care physicians (family medicine, internal medicine), with 59% expressing dissatisfaction with the tradeoff between patient care and the administrative tasks they are required to perform.
Fear of being sued
The 2013 study again found that the fear of being sued continues to have a negative influence on physicians and the practice of medicine, though less than in previous years. This finding is consistent with the Society’s previous workforce studies.
36% of physicians said they have altered or limited the scope of their practice because of the fear of being sued – a drop of 5% from 2012.
A third or more of physicians in eight specialties said they have altered or limited their practice because of the fear of being sued: general surgery (64%), emergency medicine (61%), orthopedics (50%), urology (63%), neurology (45%), cardiology (41%), radiology (39%), oncology (38%), and obstetrics/gynecology (33%).
Residents + fellows' view
The 2013 Physician Workforce Study included a survey of medical residents and fellows (physicians who are continuing their training), with particular emphasis on post-training employment decisions, whether they would seek to stay in Massachusetts to practice, and how they rated Massachusetts as a place to practice medicine. Among the key findings from this part of the study:
61% of respondents said they would choose Massachusetts to begin their practice.
Respondents indicated that both professional factors, such as the practice environment and research and clinical opportunities, and personal factors, such as work/family balance, are less favorable for staying in Massachusetts to practice compared to 2011, when the last survey of residents and fellows was taken.
Familiarity with global payments remains high, with 59% of respondents indicating they are either very or somewhat familiar with global payments.
More physicians (54%, up 5% from last year) said they were likely, and fewer (46% down 5%) said they were not likely, to participate in a voluntary global payment system.
Employed physicians (61%) are more likely to participate in global payments than self-employed physicians (44%)
Familiarity with ACOs remains high, with 71% of physicians saying they were either very or somewhat familiar with ACOs.
Of those physician practices that were familiar with ACOs, 42% are currently part of an ACO.
Of those physician practices that were familiar with ACOs, more primary care physicians (49%) were part of an ACO than specialists (38%).
- CHART: New England’s Best Hospitals Rated By Patients
- Central Massachusetts Hospitals Named Safest For Surgery in State
- Controversy Surrounds Buyer of St. Vincent + MetroWest Hospitals
- Employees and Experts React to GoLocal’s First-ever Hospital Rankings
- How Central Mass Hospitals Ranked: NE’s Best Hospitals Rated By Patients
- Local Nurses Say Hospitals “Skirting the Law”
- Methodology: New England’s Best Hospitals Rated By Patients
- New England’s Best Hospitals Rated By Patients
- See Which CMass Hospitals Charge the Most to Medicare
- Tenet Purchase of Vanguard Health Includes St. Vincent Hospital
- St. Vincent’s Hospital Unveils the CyberKnife
- The Best Hospitals in Central MA
- The Top 20 Hospitals in NE Rated By Patients
- UMass Memorial Lags Behind Peer Worcester Hospitals in Nat’l Safety Scores
- What is the Best Hospital in Central Mass? Take Our Exclusive Poll
Enjoy this post? Share it with others.
Commenting is not available in this channel entry.