Number of Bay State Doctors Increases

BOSTON--The number of doctors practicing in Massachusetts has risen in the last decade, according to a new study of physician supply, meaning that reports of medicine's demise in the Bay State may be premature.

The Massachusetts Health Data Consortium study reported that the number of doctors in clinical practice stands at 13,895, or 34 percent above the number for 1976.

But experts warned against drawing any firm conclusions from the data because of the difficulties that arise in comparing supply and demand at different times in different places.

The findings, however, are likely to fuel the debate over access to health care and the conditions of medical practice in the state, issues that have dominated the debate over medicine during the 1980s and promise to intensify as the full impact of the state's universal health care law are felt in the next decade.

Elliot Stone, executive director of the Health Data Consortium, refused to draw conclusions from the data, saying his group's goal was to supply information, not shape policy.

The report was presented this week to the state's Special Commission to Study Physician Shortages in Massachusetts, which was established earlier this year under the universal health care law. A spokesperson for the commission's chairperson, Human Services Secretary Philip Johnston, said the study was under review, along with other materials.

Using current data from the state Board of Registration in Medicine, the consortium study provides the greatest detail to date on the availability of doctors in Massachusetts by region and by medical speciality. The findings suggest wide variations in the number of specialists statewide.

The Boston area consistently ranked highest, both in the actual number of doctors and in the number of doctors per 100,000 residents. With 687 doctors of all types per 100,000 residents, Boston ranked well above Cambridge with 438, Newton with 404, Worcester--home of the University of Massachusetts Medical Center--with 273 and Salem with 247.

Among those areas ranked lowest in the number of all types of doctors per 100,000 population were Milford with 78, Leominster with 81, New Bedford with 82, Westfield with 91 and Lowell with 94.

Dr. William Schwartz of Tufts Medical School, a national expert on physician supply issues, welcomed the study but emphasized its limitations.

"It is obviously a very useful step forward to have data on the number of physicians who hold licenses in Massachusetts. But one has to be cautious in interpreting the significance of that number," Schwartz said in an interview.

"For example, when dealing with a major medical center such as Boston you can expect an unusually high ratio of physicians to population because many patients are referred to teaching hospitals from out of state and even from out of the country.

"How important this is in looking at the entire state of Massachusetts is obviously unclear. But it simply indicates that overall numbers have to be interpreted with some caution," Schwartz said.

John Larkin Thompson, president of Blue Cross and Blue Shield of Massachusetts, said the study would be particularly helpful in tracking trends if it is repeated in the future using the same methods.

According to the report, 23,106 doctors hold licenses in Massachusetts, although 1234 are "inactive."

Of the remaining 21,872 active physicians, 78.7 percent work in a clinical setting such as hospitals, clinics, HMOs or solo and group practices. Most of the Massachusetts licenseholders practice here, but 18 percent of the clinicians work outside Massachusetts.

The study also examined the supply of certain medical specialties that have been the focus of debate in recent years.

In obstetrics, for example, the study reported the greatest concentration of doctors in Boston, Cambridge, Newton, Salem and Springfield. The lowest concentrations were reported in Westfield, Leominster, New Bedford, Attleboro and Milford.