THE ISSUE
The COVID pandemic accelerated and exacerbated the critical workforce issues facing health care broadly and physicians in particular. The United States faces a severe shortage of physicians in the coming years, a crisis that could push our already fractured
health care system beyond the brink. A comprehensive report by the Association of American Medical Colleges concluded that by the year 2034, our nation will
be short more than 120,000 physicians.
Physicians in Massachusetts are experiencing unprecedented levels of burnout, resulting in more and more physicians reducing their clinical care hours or leaving the practice of medicine. There are a multitude of factors contributing to physician burnout,
including increased administrative burden, workforce shortages, escalating practice costs, including markedly increased labor costs and historic inflation, which are compounded by the financial instability caused by low reimbursement for patients
who are insured through MassHealth and continuous threats of Medicare payment reductions for physician practices. The core challenges facing the physician workforce can be viewed in three categories: pipeline, practice of medicine, and payment. The
pipeline—the supply of new incoming physicians—is insufficient to meet demand and lacks the diversity needed to optimally treat patient populations. The practice of medicine, beset with administrative burdens and an often-unforgiving workplace culture,
is burning physicians out and pushing them to reduce their clinical hours or out of medicine altogether. Finally, low rates of payment, particularly in primary care, threaten the sustainability of physician practices, especially independent practices
with high public payer patient populations. Changes are needed in all three of these areas to make the practice of medicine a more accessible, inviting, and sustainable profession.
OUR STANCE
There is a clear and present need to address not only the dearth of physicians society will face in the next decade but also the lack of diversity within our physician workforce. The MMS recognizes that the workforce challenges we are facing are varied
and require a flexible, multi-pronged approach, and we are prioritizing advocacy and collaboration with other key stakeholders to advance policy reforms in each of the core categories affecting the physician workforce. Our advocacy priorities include,
but are not limited to, pipeline advocacy to broaden and expand loan repayment programs to include private practices with high Medicaid populations; and reforming the prior authorization process to reduce the administrative burden on physicians and
improve the practice of medicine. Payment reforms include seeking sustainable reimbursement rates, increasing investment in primary care, and transforming how we pay for primary care. By taking a multi-pronged approach and advocating for key reforms
in every category that create challenges for the physician workforce, we are seeking to make the practice of medicine a more accessible, inviting, and sustainable profession.
OUR ADVOCACY
- The Massachusetts Medical Society survey “Supporting MMS Physicians’ Well-Being Survey and Report”
has provided invaluable data quantifying and substantiating the challenges physicians are facing in the workplace. This resource highlights important disparities by gender and race and variability in practice environments and years of practice
and makes recommendations. These survey findings are in general agreement with recent national data on physician burnout[1].
- The strain staffing shortages are putting on the system is reflected in the Massachusetts Health & Hospital Associations 2022 report: An Acute Crisis: How Workforce Shortages are Affecting Access and Costs.
- The Medical Society supported several bills seeking to develop
the health care workforce pipeline:
- An Act relative to the primary care workforce development and loan repayment grant program at community health centers (H.1245/S.781)
- An Act to promote primary care through Medicaid graduate medical education funding (H.1170/S.798)
- An Act to promote graduate medical education (H.1226/S.765)
- See Valuing Primary Care to learn more about MMS advocacy efforts supporting payment reform.
- See Administrative Burden and Physician Burnout to learn more about MMS advocacy efforts to improve the practice of medicine.
- See Medicare Payment Reform to learn more about MMS advocacy efforts to stop reductions in Medicare payments.
[1] https://physiciansfoundation.org/research/amplifying-physician-resident-and-student-voices-to-drive-wellbeing-and-care-delivery-solutions/
