The environment for physicians in Massachusetts worsened in 2002 for the ninth consecutive year, driven primarily by rising premiums for medical malpractice coverage, says a report released yesterday by the Massachusetts Medical Society.
The MMS Physician Practice Environmental Index measures factors that impact the conditions in which doctors provide care in the state. The index dropped 3.9% in 2002, the second largest decline in the history of the index.
The complete report is available on the MMS Web site.
MMS developed the index to evaluate the influence of nine indicators representing three primary physician practice environment factors--supply of physicians, practice financial conditions and physicians work environment.
"Plunging reimbursements, the increasing cost of doing business and overwhelming administrative inefficiencies are affecting physicians of all specialties in all regions of the state," said MMS President Thomas Sullivan, M.D., in a statement. "On top of all this, the huge jump in medical liability insurance premiums is like the proverbial 'straw that breaks the camel's back.'"
"This nine-year decline is taking a toll on the physician workforce population, and the news is not good for doctors," Sullivan said.
The report said professional liability rates rose 12.5% in 2002 and are predicted to rise another 20% on average in 2003. Those rising rates have had significant influence on the total cost of maintaining a practice, which jumped 66% in Massachusetts from 1992 to 2002.
Also influencing the practice environment index decline was a 9.9% drop in applications to Massachusetts medical schools and the ratio of housing prices to physician income, which rose 7.9%, according to the MMS report.
In the decade between 1992 and 2002, the Massachusetts index declined 22.6%, compared with 15.3% for the U.S. Physician Practice Environment Index.
"What should be a great cause for concern are three factors," said economist James Howell, who developed the index with the medical society. "First, that we've had nine straight years of decline; second, that since 1999, the rate of decline has accelerated; and third, that the Massachusetts index is falling much more rapidly than the rest of the nation."