Thursday August 9, 2012

Confirming what many area residents already know from personal experience, the Massachusetts Medical Society's study of patient access to medical care offers dramatic evidence of Berkshire County's severe shortage of primary caregivers.

The data, gathered this past February through April and released on Wednesday, does not reflect recent or pending departure or scale-downs of nearly a dozen practices from North Adams to Great Barrington.

But it shows that while it's relatively easy and quick to see a pediatrician or certain medical specialists in the Berkshires, internists and family-medicine doctors are overbooked. Many doctors are not accepting new patients and those who do often exclude seniors on Med icare or residents on Mass Health (Medicaid) or state-subsidized Common wealth Care.

For example, all of the county's pediatricians, orthopedic surgeons and gastroenterologists were accepting new patients at the time of the survey. Among obstretricians-gynecologists, 86 percent were.

But only 57 percent of internists could take on new patients; among family-medicine physicians, 43 percent had open practices. Cardiologists were the only specialists very difficult to see: just 25 percent would accept new patients.

By comparison, in early 2011, 71 percent of family practitioners were taking on new patients, along with 57 percent of internists, the same as in 2012.


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Orthopedic surgeons and pediatricians all had open practices last year; figures were lower in 2011 for other specialties.

Waiting times to see a doctor are another hurdle for Berkshire patients seeking general care. In this year's survey, it took three months to get an appointment with an internist, and nearly a month to see a family practitioner or an OB-GYN.

For pediatricians, the average wait time was two weeks. Gastroenterologists required a wait of a month and a half. But heart specialists could see patients within several days and an appointment with an orthopedic surgeon could be booked within two weeks.

Another challenge for low- to moderate-income Berkshire residents: Fewer than half of fam ily doctors would see Mass Health clients, and only three out of 10 internists would. Among pediatricians, a paltry 13 percent accepted Mass Health youngsters earlier this year.

Lower reimbursement rates for federal-state MassHealth (Medicaid) insurance have been cited by child-care physicians as reasons for their policy.

On the other hand, all the specialists for adults accepted the government-subsidized insurance.

For seniors, the picture was brighter. Nearly three out of four internists would see Medicare patients, and just over half of family-medicine practices were willing to do so. Again, among the specialists surveyed, all accepted Medi care insurance.

The Massachusetts Medical Society's annual study painted a brighter portrait statewide, although two counties, neighboring Franklin and Barnstable on Cape Cod, faced even tougher problems than Berk shire County.

"Our latest research shows an improving picture of access to and satisfaction with health care in the Commonwealth," stated the society's president, Dr. Richard Aghababian. "While we continue to have shortages of physicians and average wait times for new patients for primary care are still longer than we'd like them to be, we are seeing more people getting care. And that's positive."

Availability of primary care improved only slightly this year compared to 2011 across the state, with nearly half of the practices still closed to new patients. The access changed only marginally over the past three years, according to the medical society.

Delays in obtaining appointments averaged 45 days for family medicine and internal medicine throughout Massa chu setts, with some improvement for internists but a dramatic increase in wait times for family doctors.

Wait times to see specialists were either stable or shorter, according to the study.

To reach Clarence Fanto:
cfanto@berkshireeagle.com,
or (413) 496-6247
On Twitter: @BE_cfanto


Medical care snapshot ...

The following data shows the percentage of open medical practices in Berkshire County:

In 2012:

Cardiology 25%

Family medicine 43%

Internal medicine 57%

OB-GYN 86%

Pediatrics 100%

Gastroenterology 100%

Orthopedic surgery 100%

In 2011:

Cardiology 20%

Internal medicine 57%

Family medicine 71%

Gastroenterology 80%

OB-GYN 86%

Orthopedic surgery 100%

Pediatrics 100%

The following chart lists waiting times earlier this year for practices and the percentage accepting Medicare or MassHealth (Medicaid):

Cardiology 2 days Medicare 100% MassHealth 100%

Orthopedic surgery 10 days Medicare & MassHealth 100%

Pediatrics 13 days MassHealth 13%

Family medicine 25 days Medicare 57% MassHealth 43%

OB-GYN 26 days Medicare & MassHealth 100%

Gastroenterology 46 days Medicare & MassHealth 100%

Internal medicine 90 days Medicare 71% MassHealth 29%

Source: Massachusetts Medical Society, founded in 1781, located in Waltham and representing about 24,000 physicians and students. The study was based on 830 telephone interviews with physicians' offices statewide between Feb. 28 and April 2 this year.