A macro model of change in specialty and spatial distribution of physicians in Canada, 1971-1981

Most studies on physician distribution have examined static relationships involving the influence of such factors as socio-economic status. This study employs a causal model to study change in physician ratios (general practitioners and family physicians, and specialists) between 1971 and 1981 as a function of change in hospital bed ratios, population size, age distribution, educational attainment of the population, population "native", owner-occupied dwellings, and geographic proximity to the nearest metropolitan area, using physician data for 189 Canadian census divisions. The results, derived from LISREL VI analyses, indicate that specialists experienced increases in their supply in higher socio-economic status areas and in those areas losing general practitioners and family physicians (from 1971 to 1981). General practitioners and family physicians appear to have moved into areas with a relatively low percentage of owner-occupied dwellings and areas where a large percentage of the population is "native". Both groups of physicians appear to have increased in areas where there were increases in hospital facilities over the decade. The study confirms the known association between the two physician groups; that is, general practitioners and family physicians increased in areas gaining specialists and specialists increased in areas where considerable decreases in general practitioners and family physicians were occurring. Findings are discussed in terms of implications for physician manpower planning.