Tuesday, October 14, 2008

Massachusetts: Doctors shortage imperils healthcare pledge

Primary care doctors are in “critically short supply” in Massachusetts, a shortage that poses a threat to the state’s healthcare reform initiative and underscores a nationwide problem that could hinder efforts to enact universal healthcare.

According to a report by the Massachusetts Medical Society, an inadequate supply of primary care physicians and certain specialists, including oncologists and neurologists, puts in doubt the state’s “ability to efficiently handle the increased demand for health services”.

“If the trend continues it won’t matter if everyone has health insurance; there won’t be a doctor to go to,” said Dr Bruce Auerbach, the group’s president. “The workforce issue is at the core of our provision of healthcare.”

The healthcare plan, which was signed into law in April 2006 by Mitt Romney, the former Republican governor, has resulted in new healthcare coverage for more than 400,000 residents. As a result, the state has seen rising demand for primary healthcare services that cannot be met with the its supply of physicians.

Primary care doctors are those to whom patients turn with sore throats, sinus problems and sprained ankles. They also work on chronic care and preventative care, by helping patients maintain health with immunisations and cancer screenings.

The dearth of primary care doctors is a problem across the US, according to Jim King, president of the American Academy of Family Physicians. “Essentially, the situation in Massachusetts reflects the fact giving everyone a health insurance card will not guarantee access to care unless public policy also solves the problem of [the shortage of] primary care physicians,” he said.

The number of medical graduates opting for residencies in family practice, internal medicine and paediatrics dropped 7 per cent from 1995 to 2006, according to congressional testimony earlier this year from the Government Accountability Office.

Dr King said that today’s medical students were not choosing careers in primary care because it does pay enough and is not seen as a particularly desirable lifestyle. “They go through medical school and accumulate huge debt of $150,000-$200,000 and see that if they enter a speciality field, rather than family medicine, they can earn a lot more,” he said. ‘There is also the misconception that family physicians are always on call: no time for family.”

Bill Draycos, director in PwC’s health advisory practice, noted that many medical schools have increased enrolment and have added branch campuses to deal with the shortage. Several states, including Arizona and Florida, have opened new schools. “But we won’t see the benefit for another eight to 10 years,” he said.

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