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Distribution of the Georgia Pulmonology Workforce: A Rural-Urban Analysis
Shervin Eskandari1, Dev Shah1, William E Long1
1From the Medical College of Georgia.
Objectives:
Although healthcare disparities between rural and urban populations are documented, access to pulmonary subspecialty care in rural regions is not well characterized. This study aimed to quantify rural-urban disparities in access to pulmonology, pulmonary critical care medicine (PCCM), and sleep medicine physicians in Georgia.
Methods:
The Georgia Composite Medical Board's 2024 Physician Workforce Database was used to identify pulmonologists, PCCM, and sleep medicine physicians and their primary office location. County-level data were obtained using the US Census. The 2023 Rural-Urban Continuum Codes were used to classify counties as metropolitan (codes 1-3) or nonmetropolitan (codes 4-9). Physician density was calculated per 100,000 residents and per 100 mi2. Travel burden was calculated as the linear distance from each county centroid to the nearest physician practice.
Results:
A total of 122 pulmonologists, 204 PCCM physicians, and 49 sleep medicine physicians were identified across Georgia's 159 counties (74 metropolitan and 85 nonmetropolitan). Nonmetropolitan counties contained only seven pulmonologists, 16 PCCM physicians, and two sleep medicine physicians. Most physicians practiced in counties classified as code 1 (most urbanized), which also had the lowest travel burden. Metropolitan counties had an average of 0.67 pulmonologists, 1.06 PCCM physicians, and 0.20 sleep medicine physicians per 100,000 residents, compared with 0.20, 0.41, and 0.07/100,000 residents in nonmetropolitan counties (P < 0.001). In addition, travel burden to the nearest physician was significantly greater in nonmetropolitan counties across all three subspecialties (P < 0.001).
Conclusions:
There are significant rural-urban disparities in access to pulmonary subspecialty care in Georgia, with severe shortages in rural counties.
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