BOSTON—Massachusetts has the highest percentage of insured residents of any state, but access to medical care, especially to primary care doctors and a wide number of specialists, continues to be tight.
More than half of family primary care practices said they were not accepting new patients this year, the highest it's been in four years, according to an annual survey by the Massachusetts Medical Society.
Access to specialists is also tightening again.
Ten of 18 specialties, including emergency medicine, general surgery, orthopedics, and psychiatry, have been found in short supply. That's three more than last year, according to the study.
The survey also found that the wait time for new patients seeking doctors specializing in internal medicine increased to 53 days, the highest in six years.
"The state's universal health care plan has improved access to care," said Dr. Alice Coombs, M.D., President of the Massachusetts Medical Society, "but universal coverage and access can only be sustained with a strong physician work force."
One reason for the shortage of primary care doctors is an ongoing trend among medical students to pursue higher paying specialties. While that is less of a problem in Boston, which has several teaching hospitals, it's more of a factor outside the city.
Another reason is increased demand. The state has added more than 400,000 people to the rolls of the insured since Massachusetts' landmark 2006 health care law took effect.
There were some bright spots in the survey.
Access to obstetricians and gynecologists was no longer considered in short supply. OB-GYNs were reported in short supply last year for the first time in the survey, but fell off the list this year. This is the ninth annual survey by the group.
Also for the first time, slightly more doctors said they were satisfied with the medical practice environment in Massachusetts than those who said they were not satisfied.
But overall the survey of teaching hospitals, community hospitals, practicing physicians, medical directors, and resident and fellow programs found doctors in short supply.
The survey found that from 2006 to 2010, 11 specialties have been in short supply in at least three of those five years. They include family medicine, internal medicine, vascular surgery, urology, dermatology, neurology, psychiatry, general surgery, orthopedics, emergency medicine, and neurosurgery.
The shortages at community hospitals was especially acute with all of the facilities saying they were having trouble filling positions.
Sixty-four percent of community hospitals said shortages of doctors forced them to alter the services they provide -- an increase from 43 percent in last year's study.
The survey also found geographical disparities when it comes to doctor shortages.
Of five metropolitan regions -- Boston, Worcester, Springfield, New Bedford and Pittsfield -- all but Boston reported physician shortages, with the most critical shortages in Worcester and in the Pittfield/Western Massachusetts region.
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On the Net:
Massachusetts Medical Society: http:http://www.massmed.org/workforce
