In 2008, I was interviewed by the New York Times about the dearth of primary care physicians in western Massachusetts [“In Massachusetts, Universal Coverage Strains Care,” NYT, April 5, 2008]. The Times interviewer made me prove my numbers to him when I stated that every time we saw a patient with MassHealth for insurance it was the equivalent of handing the patient $20 at checkout. That holds true today but the number is upwards of $50 with every patient visit.

MassHealth is an abysmal payer with the most restrictions; very limited prescription formulary, harder to find specialists or dentists who can see the patients, no-show fees are not permitted and the reimbursement to our behavioral health therapists is even worse.

Primary care is at an all-time crisis in our area. There are currently no (count them, none) primary care physicians accepting new patients. There continue to be large numbers of physicians retiring or fleeing the state in every specialty so that the wait for ENT, neurology, cardiology exceeds an optimal timeline for our patients. Insurance companies have ramped up the administrative burdens which they had loosened during the pandemic so that we are fielding more calls each day from frustrated patients who are unable get their prescriptions or referrals.

Overhead costs for medical offices are at an all-time high as equipment and supplies are 25% more expensive and payroll is 30-40% higher than pre-pandemic but physicians are not allowed to set our rates like other businesses. We cannot charge more and our payments have actually gone down.

While I still firmly believe that the only true option for health care overhaul in the U.S. is Medicare for All, in the short run we need to ask our elected representatives to help take the heat off medical practices in the commonwealth. High deductibles shouldn’t be applied to doctors’ office visits (please ask your state senators/reps to support H.1195/S.679). Preventive care works and actually decreases health care costs. Generic drugs should be accessible to patients without prior authorization paperwork. And Massachusetts needs to do everything they can to increase primary care in the state starting with higher payment by MassHealth to medical and behavioral providers. Finally, you can also ask your reps to support PC4You which is legislation to strengthen primary care.

Please speak out before western Massachusetts loses any more medical practices or doctors.

Dr. Katherine J. Atkinson of Amherst is with Atkinson Family Practice and an assistant professor with Family and Community Medicine, at the UMass Chan School of Medicine. 

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