UMass Medical School survey finds community health center physicians mission-driven but notes continued challenges with long-term commitment

August 22, 2016

A UMass Medical School survey of primary care physicians (PCPs) at Massachusetts community health centers (CHCs) finds a workforce more prepared to practice in a health center through training while also citing concerns of an aging workforce, according to an article in the Journal of Health Care for the Poor and Underserved.

“Massachusetts has often been in the forefront of advancing the importance of CHCs and their mission while also leading health care reform,” the authors concluded. “The aging of this vital workforce and the 10-year retention estimates are concerning. This challenge, and the feedback from PCPs, underscores the need for: support for medical schools and CHCs to provide opportunities for medical students to learn from PCPs who are passionate and model the CHC mission; the continuation of training grants which favor curricular innovations aimed at caring for underserved populations; training for students, residents, and practitioners about interprofessional team-based care; and creative recruitment and retention programs.”

The article is co-authored by a team from UMass Medical School’s Commonwealth Medicine division, including Judith Savageau, MPH, research associate professor in Family Medicine and Community Health at UMass Medical School and research faculty in the Center for Health Policy and Research (CHPR); Linda Cragin, MS, instructor in Family Medicine and Community Health at UMass Medical School and director of the Massachusetts Area Health Education Center (MassAHEC) Network; Warren Ferguson, MD, professor in Family Medicine and Community Health at UMass Medical School and medical director of MassAHEC Network; and Laura Sefton, MPP, project analyst in the Research and Evaluation unit of CHPR. Joan Pernice, RN, MS, of the Massachusetts League of Community Health Centers also is an author.

The article compares the findings of a 2008 statewide survey, which was done shortly after Massachusetts implemented health care reform, and a follow-up survey in 2013 to determine the effect of reform on community health centers.

Key findings of the 2013 survey are:

  • Wanting to “work for an organization whose mission I believe in” ranked highest and was rated “important” by 89 percent of respondents and was consistent over the five years.
  • A statistically significant gain from 80 to 87 percent of PCPs in 2013 reported feeling “prepared” to work with underserved populations.
  • A statistically significant gain was also seen in language competency with nearly three-quarters (73 percent) of PCPs reporting speaking at least one non-English language sufficient to conduct a patient history and physical exam.

A third of the PCP workforce who responded to the survey have been at CHCs for fewer than five years, showing both growth in health centers as well as turnover. The authors found an increased importance on retention strategies such as work/life balance (94 percent), support staff and operational support (90 percent), informational technology (87 percent), and professional development (83 percent).

The 2013 survey included 301 PCPs from 44 CHCs throughout the state. Their responses can inform advocates, executive leaders, policymakers, and educators in the implementation of primary care training and workforce initiatives, and the redesign of practices, the authors said.