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Massachusetts’ primary-care crisis requires urgent action – The Boston Globe

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Massachusetts’ primary-care crisis requires urgent action – The Boston Globe


Slots for primary-care training, including family medicine, pediatrics, and internal medicine, also increased by 877 positions this year, offering up to 20,300 positions for the nation. This seems like promising news for a city like Boston, where the wait for a new patient to access primary care is at least 40 days, twice as long as in 15 other studied cities, and up to half of the primary-care workforce is close to retiring age. The most recent primary-care dashboard from Massachusetts Health Quality Partners, a measurement and reporting nonprofit organization, shows that these shortages are driving up visits to emergency departments, spiking Massachusetts’ total cost on health care, and disproportionately affecting low-income people and people of color, further aggravating our state’s health inequities.

The small increase in slots to train future primary-care physicians nationally will not come close to fixing our primary-care crisis in Massachusetts, however. In a state that has more physicians per capita than any other in the United States, only 22 percent of Massachusetts medical school graduates were providing primary care six to eight years later, as of 2023.

Further, not all primary-care training programs are equal in terms of generating practicing primary-care physicians. According to a recent study, 97 percent of family-medicine residents conclude their training in primary care, whereas only 54 percent of pediatric residents and 35 percent of internal medicine residents conclude their training in primary care. In other words, the vast majority of new primary-care physicians in the United States are family-medicine physicians. Given the robust training of family-medicine physicians, including caring for prenatal, postpartum, pediatric, adult, and geriatric patients, this workforce is crucial.

However, while 13.4 percent of first-year residency positions were in family medicine nationally, Massachusetts only provides 3.9 percent of its first-year residency slots in family medicine. Given that studies show the vast majority (68.7 percent) of family-medicine graduates continue to work in the state where they trained after graduation, this anemic number is a poor harbinger for our future.

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A significant barrier to training more family-medicine physicians is the lack of academic medical support. Apart from Boston Medical Center, there are no family-medicine departments in Boston’s academic medical centers, where the majority of graduate medical education occurs. The rationale often cited is that it is the responsibility of community-based institutions to train future primary-care and family-medicine doctors. However, it is exceedingly difficult for community-based hospitals and community health centers to take on this responsibility with already tight profit margins, a lack of internal infrastructure to support residency programs, and traditional residency program funding flowing to academic medical centers.

If Massachusetts wants to have adequate access to primary-care physicians, it needs to prioritize and organize state-level partnerships between large academic institutions and community-based institutions, particularly community health centers, to develop infrastructure and funding for new family-medicine residency programs. Academic medical centers must include investments in developing family medicine as part of their larger primary-care investment plans. Legislators must also reinstitute Medicaid Graduate Medical Education funding in Massachusetts that is targeted to support family-medicine training programs. Currently, Massachusetts is one of only seven states that does not fund residency programs through this program.

Furthermore, to attract more motivated and capable medical students to enter the field of family medicine, health care leaders, educators, and policy makers must work to make the job more sustainable. This includes actions such as statewide policies increasing reimbursements for family-medicine services from all payers, streamlining the number of health care metrics family-medicine physicians are accountable for, and reducing the administrative burden of family-medicine physicians by accelerating the use of AI to complete forms for items such as durable medical equipment, prior authorizations, and messages generated through electronic medical systems.

We are grateful to Governor Maura Healey for her recent remarks on prioritizing primary care; to the Legislature for the development of the Primary Care Task Force, which will focus on primary care access, delivery, and financial sustainability; and to the recent Massachusetts legislative hearings on Senator Cindy Friedman’s Primary Care for You bill. However, we cannot wait for the group’s recommendations to start addressing our state’s primary-care crisis. Legislators, payers, hospitals, and community health centers must work now to strengthen and grow the family-medicine workforce, build a stronger pipeline, and pay for a health care system that will build a healthier Commonwealth.






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Massachusetts

The challenges and joys of being a Christmas tree farmer in Massachusetts

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The challenges and joys of being a Christmas tree farmer in Massachusetts


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Christmas tree season is short, intense, and years in the making.

The MacNeill family are the new owners of River Wind Tree Farm in Lancaster, Massachusetts. (Photo by Susan Unger Snoonian Photography)

Christmas tree farmers across Massachusetts had their own kind of Black Friday this year. On Nov. 28, Governor Maura Healey dubbed the day “Green Friday,” a push to kick off the holiday season while spotlighting the state’s Christmas tree and nursery industries.

While shoppers elsewhere woke before dawn to map out traffic-free routes, scour deals, and stack lawn chairs in car trunks to claim a place in line, farmers were already in the thick of a different kind of rush — one that had been years in the making.

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The Christmas tree season, after all, begins long before the holidays arrive. For Meagan MacNeill, the new co-owner of River Wind Tree Farm in Lancaster, this year marked her very first season in the business. And as it turned out, she was unprepared, she said.

Customers began gathering at 9 a.m., an hour before opening, eager to flood the fields and begin their search for the perfect tree. It was all-hands on deck for the MacNeills; Meagan assembled both her immediate and extended family to help out.

The season began and closed in a flash. They sold out of cut-your-own trees the very next day, on Saturday, Nov. 29, and of pre-cut trees two weekends later.

The one word Meagan used to describe the season? “Insanity,” she said without missing a beat.

“I think it’s a new Olympic sport, getting the biggest and best Christmas tree,” she added with a laugh.

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The challenges

The MacNeills are one of 459 Christmas tree farms across the state, which operate on nearly 3,000 acres of land and contribute more than $4.5 million to the local economy every year.

Like MacNeill, many farmers sold out of trees quicker this year than in years past (particularly since before the pandemic), according to David Morin, the communications liaison and former president of the Massachusetts Christmas Tree Association. He also owns Arrowhead Acres in Uxbridge, a Christmas tree farm and wedding venue.

Pre-pandemic, he was open for four weekends: Thanksgiving weekend, plus the three following it. He doubled his sales in 2020 during the pandemic. Now, he’s struggling to meet demand with a lower inventory.

“I was lucky to make it through two weekends. I actually shut down early on the second weekend because I didn’t have enough trees,” he said. 

Valentina Encina, 6, dashes between trees while hiding from her family at Holiday Tree Farm in Topsfield, MA on December 6, 2025. (Craig F. Walker/Globe Staff)

It’s not just that individual farms are struggling to meet demand, but that the number of farms nationally are dwindling. Between 2002 and 2022, the number of farms growing Christmas trees fell by nearly 30%, down from more than 13,600 to about 10,000, according to the American Farm Bureau Federation, an agricultural organization.

Why are there fewer farms? Illan Kessler, who operates North Pole Xmas Trees, a wholesale grower in Colebrook, New Hampshire and choose-and-cut Noel’s Tree Farm in Litchfield, attributed the decline to farmers aging out of the industry. This, coupled with a lack of interest from the next generation to continue the business, means fewer farms.

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“They get older, and then no one takes over, so there’s less and less tree farms,” he said.

It takes between seven and 10 years to grow a Christmas tree. Farmers are competing not just with national chains like Home Depot or Walmart — which “are super-influencers when it comes to price,” Kessler said — but also with artificial Christmas tree suppliers. 

“The artificial Christmas tree companies make so much revenue that they have a marketing budget that eclipses — at a magnitude of thousands-to-one — what real Christmas tree growers have to promote and market their own products,” Kessler added.

Jeff Taylor prepares a price tag for a Christmas tree on Windswept Mountains View Christmas Tree Farm in Richmond, New Hampshire November 19, 2025. (Jessica Rinaldi/Globe Staff)

Prices of trees have gone up this year compared to last too, driven by inflation and tariffs along with a dwindling labor force and increasing costs of seedlings and machinery, Kessler and Morin said.

Morin likened being a Christmas tree farmer to a “love-hate” relationship. 

“The week after you’ve sold the trees, you’re in love with them. But for the other 11 months of the year, if it isn’t gypsy moths or caterpillars or one kind of a bug or another, or lack of rain or too much rain, it’s a constant hassle,” he said.

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But despite it all, they wouldn’t give it up for the world.

“It’s like a Hallmark movie,” said Kessler. “We love selling Christmas trees, and we are super grateful to be in this business. I feel so blessed. I love what I do,” he added.

Joy to the world

Meagan and Steven MacNeill had dreamed of owning a Christmas tree farm in Vermont when they were newlyweds, but life got in the way. Before becoming farmers, Meagan worked as a school counselor, and Steven worked as a pharmacist — a job he still holds full time, she said.

“I knew, for me in particular, the traditional kind of 9-to-5 job didn’t feel right,” she said. She started working at a garden center and volunteering at an alpaca farm in Harvard on Sundays to satisfy the itch to be outdoors working in nature. Her husband later joined her at the alpaca farm, and it became their Sunday morning tradition for almost two years.

The couple bought River Wind Tree Farm in June from the Wareck family, fulfilling their two-decades-old dream to be Christmas tree farmers. 

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But it wasn’t the fairy tale they had dreamed it to be. From learning to identify the farm’s many tree varieties — including exotic Christmas trees such as Nordmann fir, Korean balsam, and noble fir — to navigating drought and pest pressures, the experience was as much a challenge as it was a labor of love for the MacNeill family.

“The way the season looked was kind of a crapshoot because we had no idea what we were doing,” Meagan laughed. “It’s been a big learning curve for us. We still have a ton to learn.”

The MacNeill family own River Wind Tree Farm in Lancaster, Massachusetts. (Photo by Susan Unger Snoonian Photography)

The MacNeills plan on adding alpacas to the farm next year, and are getting creative on keeping revenue flowing outside of the Christmas tree season by holding photoshoots at the farm.

Despite the arduous work, whirlwind season, years of preparation, and fierce competition, Meagan is grateful to be in the industry — and she’s not looking back.

For many Christmas tree farmers, herself included, the pull is hard to define. It’s rooted in community, tradition, and the simple joy of bringing people together for the holidays.

“It’s the joy of people coming to pick out their Christmas tree, and even having my family be a part of it,” Meagan said. “People coming out and just connecting to the land for a little while, or being with their family, and having these traditions that are not centered around electronics, but just being present. It’s so special.”

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The Queue: holiday streaming edition





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Driver charged in Plymouth hit-and-run

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Driver charged in Plymouth hit-and-run


Authorities said a driver is facing charges after a hit-and-run crash left a pedestrian badly hurt this weekend in Plymouth, Massachusetts.

The crash happened around 6:30 p.m. Saturday on Court Street. Police said the driver briefly stopped before fleeing the scene.

The victim was airlifted to a Boston hospital with critical injuries. Plymouth police said Monday that the patient is in stable condition and faces a long road to recovery.

The driver, identified as Francis Kelly of Plymouth, is charged with negligent operation and leaving the scene of a crash causing personal injury.

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“We would like to sincerely thank the public for the tips provided and for sharing surveillance footage that proved critical to this investigation,” Plymouth Police Capt. Marc Higgins said in a statement. “Incidents like this underscore the strength of community cooperation in supporting victims and ensuring accountability.”



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White Christmas chances rise in western Massachusetts

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White Christmas chances rise in western Massachusetts


CHICOPEE, Mass. (WWLP) – There is a chance for snow leading up to Christmas. 

In western Massachusetts, the chances for a white Christmas go up the farther north you are or the closer you are to the Berkshires. In Springfield, the chance for at least one inch of snow on Christmas Day is around 40 to 50 percent.

In Pittsfield, the chances are over 75 percent. In the extreme northwest corner of Massachusetts, near North Adams, the historical chance for a white Christmas is over 90 percent. So, it definitely helps your chances for snow if you’re in one of the higher-elevation areas.

How much snow is expected Tuesday

Light snow will begin on Tuesday around sunrise and continue on and off for much of the day until the evening.  A minor accumulation is expected in the Pioneer Valley with a few inches in the hills and Berkshires. Slick roads and sidewalks are possible, especially if not treated. High temperatures will be in the low to mid-30s.

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What’s the chance of a white Christmas in western Mass?

As of right now, the chances for a white Christmas this year are definitely higher than in the past few years, with some snow on Tuesday. Of course, the best chance for the snow to stick around until Christmas Day without melting will be back in the Berkshires. 

December 25 2025 12:00 am

Christmas Eve and Christmas Day both look dry and comfortable.

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