Mass. Medical Society Releases 2012 Patient Access to Care Study

WALTHAM — The Mass. Medical Society (MMS) recently released its 2012 Patient Access to Care Study, containing detailed information on wait times for new patient appointments with physicians and patient experience and satisfaction with health care in the Commonwealth.

The 2012 study consists of two separate surveys:

• A survey of physician offices examining wait times for new patient appointments, percentages of physician offices accepting new patients, and physician acceptance of the government programs of Medicare and Medicaid; and
• A public-opinion survey of Massachusetts residents looking at such issues as patient satisfaction with health care, difficulty in obtaining care, and use of online information.

“Our latest research shows an improving picture of access to and satisfaction with health care in the Commonwealth,” said Dr. Richard Aghababian, president of the MMS. “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.”

Highlights from the two surveys:

Physician-office Survey

This year’s study represents the MMS’s eighth annual examination of wait times for new-patient appointments with physicians, as well as the percentages of physician offices accepting new patients and physician acceptance of the government programs of Medicare and Medicaid. The study looked at seven specialties — internal medicine, family medicine, cardiology, gastroenterology, orthopedic surgery, obstetrics and gynecology, and pediatrics — and is based on 830 telephone interviews with physician offices conducted between Feb. 28 and April 2 of this year.

In addition to data for the state as a whole, the survey includes data for each of the 14 counties in the Commonwealth, six-year trend data for six of the specialties, and three-year trend data for pediatricians.

Access to primary-care physicians has improved in 2012, but only slightly from 2011, as nearly half of primary care practices — 49{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of internists and 50{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of family physicians — are still closed to new patients.

The three-year trends for primary-care offices that are accepting new patients are:

• 2012: 51{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of internists, 50{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of family physicians:
• 2011: 49{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of internists, 47{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of family physicians; and
• 2010: 51{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of internists, 46{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of family physicians

Meanwhile, average wait times for new-patient appointments in primary care remain long, at 45 days for family medicine and 44 days for internal medicine, though the three-year trends for each are different. The trend for internal medicine has been decreasing (down from 53 days in 2012, 48 days in 2011), while the trend for family medicine has been increasing (up from 29 days in 2010, 36 days in 2011).

For family medicine, wide variation exists in average wait times, with Plymouth County seeing the shortest average time at 19 days, and Franklin County, where just one office was accepting new patients, having the longest single wait time at 205 days. Suffolk and Essex counties have the lowest single wait time at one day.

For internal medicine, average wait times run from 22 days in Bristol County and 23 days in Essex County to 99 days in Hampden County, 90 days in Berkshire County, and 89 days in Barnstable County.

For pediatrics, the average wait time for pediatricians — primary care for youngsters up to age 18 — is 23 days, one day shorter than last year. Seventy-two percent of pediatricians are accepting new patients.

All four specialties reported nearly stable or shorter wait times than last year: gastroenterologists, 44 days, up from 43 days; obstetricians/gynecologists, 38 days, down from 41 days; orthopedic surgeons, 16 days, down from 26 days; and cardiology, 29 days, up from 28 days.

Access to specialists is easier than primary care, with 84{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of cardiologists, 86{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of obstetricians/gynecologists, 92{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of gastroenterologists, and 98{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of orthopedic surgeons accepting new patients.

Acceptance of Medicare remains almost universal in each specialty. For each of the four specialties of orthopedic surgery, gastroenterology, cardiology, and obstetrics/gynecology, 99{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of physicians are accepting Medicare. Primary care has the lowest acceptance rates of Medicare: 90{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} for family medicine and 84{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} for internal medicine.

Acceptance of Medicaid (Mass-Health) in 2012 saw decreases in four specialties: orthopedic surgery 78{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}, down from 82{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}; cardiology, 83{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}, down from 92{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}; obstetrics/gynecology, 87{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}, down from 89{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}; and pediatrics, 86{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}, down from 89{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}. Gastroenterology increased to 92{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} from 85{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}. As with Medicare, primary-care specialties are the least likely to accept Medicaid, with internal medicine at 54{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} and family medicine at 64{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}.

Public-Opinion Survey

The society’s public-opinion surveys, conducted periodically over the past decade, charts factors related to residents’ satisfaction with and access to health care services. The 2012 findings are compared to the results of 2008, the most recent year the survey was conducted. Results are based on a random telephone survey of 403 adults conducted in February. Among the findings:

• Satisfaction with health care: 87{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of residents are satisfied with the health care they received (61{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} very satisfied, 26{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} somewhat satisfied). Satisfaction has remained remarkably stable since the MMS first reported this data eight years ago.
• Obtaining needed care: 78{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} said their experience in getting care, whether for a routine or serious problem, was not difficult, a jump of 21{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} from the previous survey in 2008.
• Primary-care appointments: 90{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of residents reported seeing a primary-care physician within the last year, marking the highest reported visitation rate since the MMS first asked the question in 2003. Among those who saw a doctor, 89{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} said the amount of time they waited for an appointment did not cause them any problems.
• Non-physician medical visits: More residents (48{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}) reported seeing a nurse, nurse practitioner, or physician assistant than in 2008 (39{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}). Among those who saw a non-physician, 53{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} did so by choice, and 36{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} couldn’t get an appointment with a physician.
• Where to go for care: When deciding where to go for care, 77{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} ask their primary care physician for an opinion, while 36{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} use the Internet to research doctors and hospitals.
• Information online: More residents (42{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}) know that cost and quality data on providers are online, an increase from 33{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} in 2008, but the use of such online data decreased to 54{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}, from 65{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} in 2008.
• Biggest health care issue: 50{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of adults said affordability is the single most important health care issue facing the state.