In Massachusetts, long waits for doctor visits common

BOSTON Mon May 9, 2011 12:10am EDT

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BOSTON (Reuters) - Almost everyone in Massachusetts has health insurance under a state mandate, but many doctors do not accept the subsidized insurance programs available to low-income residents, a new study shows.

Residents in some areas also face long waits in getting doctors' appointments, or find that overstretched primary care practices are not taking on new patients.

"Insurance coverage doesn't equal access to care," said Alice Coombs, president of the Massachusetts Medical Society and an emergency room physician,

Massachusetts' healthcare program was introduced five years ago by then-governor Mitt Romney, a Republican now expected to run for president in 2012 after falling short in 2008.

The state's program is often regarded as a model for President Barack Obama's 2010 healthcare reforms. Conservatives have criticized Romney for his support of the state's plan, although he has said it was designed for Massachusetts and would not work as a national plan.

The medical society on Monday issued its annual Physician Workforce survey, which was conducted in February and March. More than 23,000 doctors and students are members of MMS, which publishes the New England Journal of Medicine.

Coombs said that despite its problems, Massachusetts has done "an incredible job" with healthcare. Issues such as a shortage of doctors in poorer communities are not unique to the state, she noted.

"It's a success in terms of the number of patients who have seen a doctor in the past few years, but the physician workforce has been strained," Coombs said.

Massachusetts, like much of the nation, has a severe shortage of doctors in primary care -- internists and family physicians -- because those fields are less lucrative.

"We need more doctors in primary care. There's no getting around that fact," said Coombs.

Many primary care doctors do not accept MassHealth, the state's version of Medicaid, and even less accept Commonwealth Care and Commonwealth Choice, programs for low- and moderate-income residents.

More than half of primary care practices are not taking new patients, especially patients for whose treatment they will be paid at a much lower level than for those carrying private health insurance.

Long wait times are common -- almost seven weeks, on average, for a non-emergency appointment for internal medicine. The average wait time for pediatricians. primary care for children, was 24 days, the MMS study showed.

New patient wait times in Massachusetts jumped from 2006 to 2007 after the initial implementation of the state health care reform law, and have remained high. As a result, the rate of emergency room visits to receive care has also stayed high.

More lucrative specialist practices -- gastroenterology,

cardiology, obstetrics/gynecology and orthopedics -- were in most instances taking new patients, although long wait times were still seen, MMS said.

"There really is a maldistribution of medical workforce resources," said Coombs.

(Reporting by Ros Krasny; Editing by Jackie Frank)

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Comments (2)
aitengri wrote:
At root, two words from within the article demonstrate why the “hypocrite’s” oath works so well in our capitalist system of medical care: “less lucrative”. Perhaps Cuba and Venezuela, or even Canada, can show us the way to a more ethical society. Facial reconstruction pays, basic health care does not.

May 09, 2011 2:27am EDT  --  Report as abuse
gzuckier wrote:
There’s no way a “free market” can provide healthcare for the disadvantaged, any more than the free market can provide automobiles and video games for them. The combination of lower reimbursements plus large average individual need for services inevitably results in higher costs for any provider who takes them on, driving their prices higher, driving the healthier and wealthier patients to shop for a cheaper alternative; the classic feedback system, which without intervention drives itself into a two phase final state, with almost everyone at one end or another of a bipolar system. It’s simple engineering/economics/mathematics theory.

May 10, 2011 10:42am EDT  --  Report as abuse
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