Massachusetts
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.
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.
Two people were seriously injured in a stabbing at the Cedar’s Mediterranean Foods manufacturing facility in Haverhill, Massachusetts, on Tuesday morning.
Haverhill police said they responded to the Cedar’s plan on Foundation Avenue around 10:30 a.m. for a report of a disturbance involving a weapon. When they arrived, they found two people suffering from apparent stab wounds.
Both people were provided with medical assistance on scene and taken to area hospitals with what police described as serious injuries. Their names have not been released, and no update on their conditions was immediately available.
Preliminary investigation determined that the two people knew each other, and police said there is no ongoing threat to the public. They said their investigation into the incident remains active.
Two Plymouth, Massachusetts teens were saved from the summit of Mount Washington after a leg injury stranded them.
Khang Nguyen,17, said he and his friend, 18-year-old Vaughn Webb, thought they were well prepared for their hike on Saturday. They brought trekking poles, layers, microspikes for their boots and more.
But halfway up the trail, Nguyen feared the worst when his leg began to hurt.
“It was just incredibly painful to lift up my right leg,” he explained. “I told [Vaughn] to leave me behind so I could go on my own pace and for him to reach the summit to get help at first.”
The pair managed to reach the top of the mountain but had to seek shelter next to a building as wind gusts increased, and the air temperature reached 38 degrees. Nguyen said they also ran out of food and water. The New Hampshire Fish and Game Department received the 911 call around 7:30 p.m. and quickly alerted a State Park employee who began to search for the two teens.
“Conservation Officers then began responding in four-wheel-drive pickup trucks to try and get to the summit and back ahead of incoming snow,” the game department said in a statement.
After around 30 minutes of reaching both Webb and Nguyen were found. They were taken inside a building and Nguyen was being treated for his injury.
“The worker that was up there, [said] that they came in record time, and we appreciate their help a lot. It saved our lives potentially,” Nguyen explained.
The pair was successfully taken off the mountain by 10 p.m. The two teens are now safely back in Massachusetts and are incredibly grateful to their rescuers.
As libraries across western Massachusetts celebrate National Library Week from April 19 to April 25, they are honoring “the last real third space where everyone is welcome,” in the words of Greenfield Public Library Assistant Director Lisa Prolman.
According to the American Library Association, National Library Week is “an annual celebration highlighting the valuable role libraries and library professionals play in transforming lives and strengthening our communities.” This year, several libraries in the region will be hosting events to highlight the roles they play in their communities.
The Athol Public Library is among the venues engaging in National Library Week festivities, with a whole host of events starting on Tuesday, April 21, with Silly Goose Story Time at 10:30 a.m. The library will hold multiple events each day, including “Free Book Friday” on April 24, which Assistant Director Robin Shtulman said is “really fantastic.”
Shtulman said the week celebrates and emphasizes the “freedom to read, community outreach and celebrating the staff, without whom nothing would happen.”
The Athol Public Library said in an event announcement that “whatever brings you joy, the library has something for everyone,” and that aspect is being emphasized this National Library Week. To name a few of the events on tap, on Tuesday, April 21, from 3:30 to 5:30 p.m., there’s a volunteer opportunity where teens will make greeting cards for senior citizens; “A Minecraft Movie” will be shown at the same date and time; and on Thursday, April 23, the library will host Scavenger Hunt Bingo for all ages. For a full list of events at the Athol Public Library, visit atholpubliclibrary.com.
In Shelburne Falls, the Arms Library will feature a gallery from the Carlos Heiligmann Collection, a series of photos of public libraries across western Massachusetts. Also in collaboration with the Arms Library, Pothole Pictures and the Shelburne Falls Area Women’s Club will partner for a screening of “Free For All: The Public Library” on Saturday, April 25, at 2 p.m. at the Shelburne Falls Theater at Memorial Hall.
The documentary focuses on the evolution of the public library from its origins in the 19th century and the challenges it faces today, with modern-day issues such as book bans, funding cuts and debates over censorship.
It also explores the role that women’s clubs, like the one in Shelburne Falls, played in creating the modern library system. To serve their communities, women’s clubs took the lead in fundraising, collecting books and advocating for library legislation.
“Our women’s club in this town started with a group of 60 women who were gathering for lessons. … Because of the support of women in the U.S., we established over 80% of the public libraries [in the country],” said Christin Couture, program chair for the Shelburne Falls Area Women’s Club. “This film … I hear it’s so fascinating.”
Following the film’s screening, there will be a panel of local librarians who will engage in “lively conversation” about the history and future of public libraries. Tickets are $6, though school-age children will be admitted for free.
In Charlemont, Tyler Memorial Library will host an open house on Saturday, April 25, from noon to 2 p.m. featuring refreshments, a tour of the library and sun catcher crafting.
The Greenfield Public Library, meanwhile, is taking National Library Week in a bit of a different direction, as it is offering a book repair demonstration with Tom Hutcheson on Thursday, April 23, at 3:30 p.m. The day marks William Shakespeare’s birthday.
Although the book repair session required registration and is currently full, those who are interested may be placed on a waiting list at greenfieldpl.libcal.com/event/16460179.
Greenfield Public Library Director Anna Bognolo recognized the hard work that everyone has put into making the library a success, offering a “huge thank you” to the volunteers and staff who make its varied offerings possible.
“Stop by and support your library,” Bognolo said.
“Libraries, especially in this economy, are more important than ever,” Prolman said. Referencing the library’s role as a place where community members can go that is not work or home, she added, “They are the last real third space where everyone is welcome, and we don’t charge you for being here.”
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