By most measures, many Massachusetts residents are finding it increasingly difficult to get appointments with doctors. In 2021, a third of patients in the state said they struggled to obtain necessary health care — a narrow increase over 2019 levels.

That shortage is taking a toll on patients. Many detail worsening health problems and expensive trips to emergency rooms. Some parents have had so much trouble finding pediatricians that they have been unable to enroll children in school or day care, since schools require health forms that must be signed by providers.

Studies have unveiled a particular challenge within primary care. In Massachusetts, the rate of doctors leaving the field exceeds the national average, and about one-third of primary care physicians are over the age of 60. Not enough young people are entering the field to take over for those who retire, due in part to lower salaries and insurance reimbursements compared with other specialties.

According to a 2021 National Academies of Sciences, Engineering, and Medicine report, 18.6 percent of adults in Massachusetts lacked a usual source of health care in 2020, up from 10.8 in 2015. For children, access also dipped. In 2015, just 0.9 percent of children in Massachusetts reported not having a usual source of health care; by 2020, that number had risen to 6.9 percent.

The problem has grown so acute, that patients calling the primary care referral line for Mass General Brigham — the state’s largest health system — are being told there are no openings at their Boston hospitals.

Finding a new doctor can itself be a months-long process, made even more difficult for patients who are immigrants and don’t speak English. Angela, who asked that her last name be withheld to protect her privacy, found a job and a day care for her then-3-year-old daughter after immigrating from Brazil in 2022. But the day care wouldn’t let her daughter attend until she had been to a pediatrician.

Angela does not speak English and said through a translator that she tried for months to call pediatricians recommended to her by the school. Unable to understand her, offices would put her on hold and disconnect her. One refused to see her daughter because of Angela’s MassHealth insurance; another declined because Angela didn’t have historical medical records for her daughter.

Ultimately, Angela connected with consumer advocacy organization Health Care For All, which helped her find a pediatrician and scheduled an appointment in July. She cried the whole day after getting the appointment, a mix of relief and exhaustion, Angela said.

But the four-month process took so long she lost the prospective job and the full-time day care spot. Angela now has her daughter enrolled in a partial-day preschool program and has to pay for a babysitter for the half day of child care. She found a different job cleaning, but she earns less than she otherwise would have.

Angela said she has given up trying to find a doctor for her 19-year-old son, herself, and her husband, who has back issues that sometimes impact his ability to work.

Read the full article on the Boston Globe.