Urban-rural flows of physicians

Area of Science:

• Health Policy
• Medical Economics
• Rural Health

Background:

• National physician supply is projected to be insufficient for requirements over the next two decades.
• Rural regions are expected to experience a disproportionately larger decrease in physician numbers.
• Informing policy decisions requires understanding anticipated changes in physician distribution.

Purpose of the Study:

• To assess the recent flow of physicians between urban and rural areas.
• To determine if physician distribution shifted towards rural settings when overall supply met needs.

Main Methods:

• Utilized merged AMA Physician Masterfiles from 1981 to 2003.
• Tracked individual physician movements between urban and rural counties over 5-year intervals (1981-2001) and a final 2-year interval (2001-2003).

Main Results:

• Around 25% of physicians relocated across county lines every five years.
• Physician distribution between urban and rural areas remained largely stable.
• A slight net migration of physicians from urban to rural locations was observed from 1981 to 2003.

Conclusions:

• A net migration of physicians from urban to rural areas suggests geographic diffusion driven by economic factors.
• Limited gains in rural physician supply may be influenced by targeted policy interventions.
• Overall physician shortages are likely to exacerbate the decline in rural physician supply relative to population needs.