Mass. Practice Environment Dips Again

MMSIndex_colorMake it 16 down years out of 18.  The MMS Physician Practice Environment, a statistical reading of nine measures affecting the practice climate for physicians in the state, took yet another dip in 2009 and hit a record low.

Four factors led the decline in 2009: professional liability rates, the increasing use of emergency rooms by patients, an aging physician population, and the increasing cost of maintaining a practice.

“A strong physician practice environment is essential to maintain a strong physician workforce,” said MMS President Alice Coombs, M.D., commenting on the analysis in a posting on WBUR’s Commonhealth website.  “And its importance should be self-evident: it has a direct influence on patient care. Yet this latest analysis brings us more sobering news.”

Of the measures leading the decline, Dr. Coombs said professional liability and emergency room use were the most troublesome. Professional liability has been the driving force behind the decline of the index for years, and Dr. Coombs said a “critical step forward to improving the practice environment would be to enact liability reform.”  The rise in emergency room use highlights a new and disturbing dimension of the index, as it points to the delivery of primary care taking place in emergency departments.

A picture of the state’s practice environment from year to year is valuable by itself. But the MMS analysis includes a index for the nation as a whole, providing a reference point to judge changes in the state.  And a comparison reveals stark differences between the state and the rest of the nation as the four factors leading the state’s decline increased at a rate substantially faster than the national rate. The conclusion: when it comes to providing a good practice environment for physicians, Massachusetts and the nation are headed in opposite directions. Since 2006, the Massachusetts Index has declined 1.5 percent, while the U.S. Index has advanced 1.2 percent.

“Reversing the decline in the physician practice environment will lead to a stronger, more viable health care delivery system,” Dr. Coombs wrote. “The current climate should be cause for concern. And action.”

Read Dr. Coomb’s post on WBUR’s Commonhealth

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