Health care providers across Massachusetts are grappling with a shortage of primary care physicians.
A recent report published by the Massachusetts Health Policy Commission (HPC) found that wait times for new patient appointments were more than twice as long in the commonwealth than in other states. That same report also noted that in 2023, 41% of Massachusetts residents reported difficulty accessing care, with the most cited reason being inability to get an appointment at a doctor’s office or clinic when needed.
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“When people have to wait three months, six months, maybe up to a year to get care that’s not in the best interest of our healthcare system,” said Michael Curry, president and chief executive of the Massachusetts League of Community Health Centers.
Both Curry and the HPC report point to current reimbursement models as a key factor driving the current challenges in primary care.
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“Reimbursement in primary care is not comparable to specialty care and many of those who are providing primary care were older they were an older generation and took the opportunity over the last several years to start winding down their careers,” said Curry. “We know that this is a chronic problem for us in the healthcare system. We have to solve for it. We have to generate more primary care. We have to spend more on primary care and invite more people into primary care to serve.”
The administrative burden is another factor identified by the HPC report, explaining that includes high-touch asynchronous messaging (such as patient portal emails), EHRs, quality measure reporting, prior authorization, and billing and coding documentation, all of which require substantial work outside of regular working hours.
“We've put several programs in place around AI to help with provider burnout,” said Dr. Ryan Boxill, chief operating officer for Neighbor Health, formerly East Boston Neighborhood Health Center. “We've implemented ambient listening and charts summarization—all these are tools that we're using, leveraging technology so that we can take a job that can be very stressful and try to decrease the burden on providers.”
Boxill says Neighbor Health also offers same-day pediatric and urgent care services without an appointment.
The helpline operated by Healthcare For All assists Massachusetts residents in enrolling in health insurance, but Director Hanna Frigand says they hear the frustrations of patients.
“I think people are feeling lost and like they don't know where to go, especially if they have conditions that they need to manage. So oftentimes we have to help people to figure out a way to access medications or even need to get urgent care services or emergency services if they are unable to get seen by a primary care physician after some time.”
Frigand recommends communicating the urgency of healthcare needs and checking in again with insurers about additional options.
“Sometimes, turning back to the health plan and seeing if they can see if there's updated panels, which means that those doctors are accepting new patients because that does change regularly. And then, so putting yourself on wait lists while still calling other doctor's offices so that you're at least waiting. And you may want to call regularly to see if there's a way to get ahead in the line or see if you can be seen any sooner because people may remove themselves from the wait list as well. And panels do change all the time. And doctors might have more openings based on how many people they can see with different health plans.”