The Massachusetts Medical Society is a professional association of over 25,000 physicians, residents, and medical students across all clinical disciplines, organizations, and practice settings. The Medical Society is committed to advocating on behalf
of patients, to give them a better health care system, and on behalf of physicians, to help them provide the best care possible. The Medical Society supports the provision of health care services by a physician-led team of health care professionals
who work collaboratively with each other and their patients to achieve shared goals through coordinated, high-quality, patient-centered care. For that reason, the Medical Society supports H.2144, An Act to Promote Team Based Health Care, which we
believe will promote integrated, coordinated care that utilizes all health care professionals in their most appropriate capacities while ensuring physicians are readily available to collaborate when needed in order to promote access to the highest
quality and safety of care for all patients.
Physician-led team-based care empowers health care professionals to perform the full range of medical interventions that they trained to perform, maximizing the full educational capacity of each team member to effectively provide quality patient care.
The extensive medical education, required medical residencies, and frequent post-residency fellowships that physicians undertake provide them with unique expertise and qualifications to manage health care teams, especially those overseeing the care
of the most complex patients. Surveys indicate that patients prefer health care teams led by physicians as patients age or when care becomes more complex. Data indicate that physicians have lower rates of utilization for unnecessary tests and higher
quality referrals to specialists, both of which contribute positively to patient outcomes and overall cost of care.
The Medical Society believes that the physician-led health care team model allows for ample access to care for patients while offering the added security of physician relationships with advanced practice nurses in circumstances where consultation or collaboration
is indicated. Patients in Massachusetts present with a wide range of acuity—some with common urgent care type needs and others with far more complex comorbidities, undiagnosed conditions, or other complications. While the training of other health
care providers is undoubtedly appropriate for certain populations of patients, there are many other patients for whom the extensive training of a physician is better suited, at least in a consultative or collaborative fashion. The Medical Society
believes it is sensible, for the protection of patients in the Commonwealth, for the legislature to ensure that established relationships are available for purposes of physician consultation on these most difficult cases. H.2144 would act in patients’
best interests by promoting a care model that ensures all patients are cared for by health care providers who have relationships with physicians and/or health care systems to allow for that immediate consultation and collaboration with a physician
when necessary.
Based on the considerations mentioned above, the Medical Society would also like to be recorded in opposition to H.2135/S.1354, An Act Relative to Removing Barriers to Care For Physician Assistants. The Medical Society is concerned that this proposal,
aimed at removing supervisory requirements for physician assistants will unnecessarily—and potentially dangerously—distance physicians from patients. The legislature, in fulfilling its duty to protect patients of the Commonwealth, has diligently established
a thoughtful, patient-focused framework of policies and statutory requirements that apply to physicians in light of their ability to independently provide medical care and oversee the care provided by other health care providers. This bill would jeopardize
the effects of these patient-centered protections and could result in a vastly varying quality of patient care.
The Medical Society is concerned that patients seen by non-physicians may not have the same standard of care, protections, or assurances experienced by patients who are seen by physicians. For those reasons, the Medical Society opposes H.2135/S.1354,
An Act Relative To Removing Barriers To Care For Physician Assistants; H.2148/S.1383, An Act Relative to The Board of Registration in Naturopathy; and H.2150/S.1453, An Act Relative to the Definition of Podiatry.
Ultimately, the Medical Society hopes that H.2144, An Act to Promote Team Based Health Care will serve as a model for cooperative, integrated health care, which best serves patients by assuring access to appropriate health care professionals throughout
the spectrum of patient need. We thank you for your consideration of our comments and look forward to providing any further input that may assist you in your deliberations.
View a PDF version of this testimony here.
