NATICK, Mass. — Leah Charofson remembers the good old days of medicine — back when a doctor’s appointment was a cut-and-dried affair.
“If you had a problem, you’d call up and make an appointment in a day or two... sometimes the same day,” the Framingham resident said.
Then came COVID-19.
“All of a sudden, no matter how sick you are, it’s almost impossible to get an appointment with your primary care physician,” Charofson said. “I just had to wait four months to get an annual Medicare examination and I could not, before that, get an appointment to see my doctor when I was sick.”
Many more will not be able to get primary care appointments in the short term after the state’s largest healthcare system announced it is not accepting new patients at its Boston locations, not the entire system.
Massachusetts General Brigham tells Boston 25 News it continues to see what it calls “historic and unrelenting” capacity issues — with some primary care physicians so backed up that six-month appointment times are not unusual. The hospital said it would not be responsible to add more patients to primary care waiting lists — as they could be waiting up to a year to see a doctor.
“It is very difficult, even for physicians today, to find a primary care doctor,” said Massachusetts Medical Society President, Barbara Spivak, MD, a primary care doctor in Watertown.
Spivak, too, says the pandemic had an effect on this.
“We saw with the pandemic many more physicians retire than we would have normally expected,” she said. “And the pipeline is less these days to hire primary care doctors.”
Primary care has become a hard sell to new medical graduates because, Spivak said, it offers more work at less money — given all the administrative tasks now required of PCPs.
“The EHR, the electronic health record, is complicated and takes longer for people to work through the number of messages that they get in their inbox,” Spivak said. “It’s very hard for someone coming out of residency training and interested in appropriately having a work-life balance who has hundreds of thousands of dollars in loans to decide to do primary care.”
Spivak said those who do will see that it offers rewards beyond money. She cherishes the relationships she has with patients — and the fact she’s taken care, in some cases, of entire familial generations.
“I love being a primary care doctor,” she said.
At present, the U.S. has about half a million practicing primary care doctors. By some estimates, close to 50,000 additional PCPs will be needed in the next ten years. But there is a foreboding sign for primary care. A recent survey of medical students by Elsevier Health found that 1/4 of them are thinking about quitting altogether — and 58% planning to pursue medical careers that do not involve direct patient care.
Spivak said the U.S. might think about following the model in other countries in which medical school loans are paid for in return for a term of primary care service.
Mass General Brigham said it is trying to alleviate the immediate problem by hiring more staff and making use of virtual options and alternative provider appointments — such as nurse practitioners and physician’s assistants.
But in the short term, Spivak worries that MGB not accepting new patients could have serious health ramifications.
“The fewer primary care doctors that are geographically close to where patients live will affect patients to get the care they need,” she said. “And unfortunately, it’s the patients with disabilities, it’s the patients of color who lack transportation who will be most affected and will end up in the emergency room more often than not for care.”
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