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How many rural doctors do we have?

T C Ricketts1, L G Hart, M Pirani

  • 1Cecil G. Sheps Center for Health Services Research, 725 Airport Road, CB #7590, Chapel Hill, NC 27599-7590, USA. tom_ricketts@unc.edu

The Journal of Rural Health : Official Journal of the American Rural Health Association and the National Rural Health Care Association
|December 29, 2000
PubMed
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Physician workforce data overcounts active doctors, especially in rural areas. Re-evaluating how we count physicians reveals a significant undersupply in nonmetropolitan communities, challenging perceptions of a physician surplus.

Area of Science:

  • Health Policy
  • Medical Workforce Analysis
  • Rural Health

Background:

  • Physician numbers in nonmetropolitan areas grew slower than in metropolitan counties over two decades.
  • A perception of physician oversupply led to policy considerations for training reform and immigration restrictions.
  • Current physician supply assessments rely on "head counts" of licensed, active physicians.

Purpose of the Study:

  • To estimate the number of full-time equivalent physicians actively practicing in North Carolina and Washington.
  • To compare the productivity of physicians in these states.
  • To re-examine physician supply data, particularly for nonmetropolitan areas.

Main Methods:

  • Utilized detailed data on licensed practicing physicians in North Carolina and Washington.

Related Experiment Videos

  • Incorporated professional activity estimates from the American Medical Association's Socioeconomic Monitoring System.
  • Calculated full-time equivalent (FTE) physician estimates and assessed comparative productivity.

    • Main Results:

    • Estimates showed actively practicing physicians were ~14% lower than head counts in North Carolina and ~10% lower in Washington.
    • National data indicated nonmetropolitan physician supply has not grown significantly in 10 years; family physician supply declined by 9%.
    • These findings support claims of a severe undersupply of practitioners in rural communities.

    Conclusions:

    • Standard "head count" methods overestimate physician supply, particularly in rural areas.
    • A more accurate measure of actively practicing physicians reveals a significant deficit in nonmetropolitan areas.
    • Re-evaluation of physician counting methods is crucial for accurate rural health workforce policy.