The good news is Massachusetts physicians can take a punch.
The bad news is they took another beating last year, sending the 2003 Physician Practice Environment Index tumbling 3.6%, a drop for the 10th straight year, according to the 18,000-physician Massachusetts Medical Society, which has kept score with the index since 1992.
Soaring medical malpractice insurance premium expenses, up 20% in 2003, were the key downward drivers of the index, followed by the number of physicians 55 years of age and older increasing by 2.4%. Also contributing to the sagging index were rising housing costs, which outstripped increases in physician income by 4%.
"How frustrating," said Thomas Sullivan, M.D., president of the Massachusetts Medical Society, in a prepared statement about the index, "that it just keeps dropping like a stone."
"And how ironic," he said, "that in a state known throughout the world for its quality of medical care, physicians in Massachusetts have faced a deteriorating practice environment for 10 straight years.
"On the plus side, it is a testament to the professionalism and perseverance of our physician colleagues that they continue to provide the quality of care they do in the face of such conditions. On the minus side, I fear we will lose more and more practicing physicians, to other states, to early retirement, and to other careers. And that will certainly affect our patients' access to care. We see it happening now."
Meanwhile, the U.S. Physician Practice Environment index dropped 4.1%, the eighth annual decline in a row.
Economist James Howell, president of the Howell Group, developed the index with the medical society. In a prepared statement, Howell said his greatest concerns are the decade-long decline and that the rate of decline continues to accelerate.
A copy of the index report is available on the Massachusetts Medical Society Web site.