NCPA - National Center for Policy Analysis


July 26, 2007

The dearth of primary-care providers threatens to undermine the Massachusetts health-care initiative, which passed amid much fanfare last year.  With the primary-care system already straining, some providers have no idea how they will accommodate an additional half-million patients seeking checkups and other routine care, says the Wall Street Journal.

According to a study by the Massachusetts Medical Society:

  • Some 49 percent of internists in Massachusetts aren't accepting new patients.
  • Boston's top three teaching hospitals say that 95 percent of their 270 doctors in general practice have halted enrollment.
  • For those residents who can get an appointment with their primary-care doctor, the average wait is more than seven weeks, according to the medical society -- a 57 percent leap from last year.

A principal reason -- too little money for too much work, says Seward:

  • Across the nation, median income for primary-care doctors was $162,000 in 2004, the lowest of any physician type, according to a study by the Medical Group Management Association.
  • Specialists earned a median of $297,000, with cardiologists and radiologists exceeding $400,000.
  • In Massachusetts, under the state-subsidized plans, doctors are often reimbursed by insurance providers -- at below-market rates comparable with Medicaid reimbursements.

"Health reform won't mean anything for the state's poor if they can't get a doctor's appointment," says Elmer Freeman, director of the Center for Community Health, Education, Research and Service in Boston.  And even though people with subsidized insurance can consult specialists within the plan's network without prior authorization from a primary-care doctor, they need such approval to visit a specialist who isn't in the network.

Source: Zachary M. Seward, "Doctor Shortage Hurts Coverage-for-All Plan," Wall Street Journal, July 26, 2007.

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