Accessibility of Otolaryngology Care in Virginia: A Geospatial Workforce Analysis

Geographic access to otolaryngologic care is a critical determinant of timely diagnosis and management for time-sensitive conditions, yet state-level disparities remain incompletely characterized. This study evaluated the geographic distribution of Virginia otolaryngologists and identified rural-urban differences in care access.

A cross-sectional geospatial workforce analysis was conducted using public data from the Centers for Medicare & Medicaid Services National Plan and Provider Enumeration System and the American Academy of Otolaryngology-Head and Neck Surgery. Otolaryngologists in Virginia were geocoded to primary practice addresses. Counties and independent cities were classified using Rural-Urban Continuum Codes (RUCC). Otolaryngologist density per 100,000 population, jurisdictions lacking in-county access, adjacency to independent cities with otolaryngologists, and fellowship training distribution were analyzed across metropolitan and non-metropolitan regions.

A total of 377 otolaryngologists were identified statewide. Per-capita availability was higher in metropolitan jurisdictions (RUCC 1-3), with a mean density of 4.67 per 100,000 population compared with 1.49 per 100,000 in non-metropolitan jurisdictions (RUCC 4-9). Overall, 67.4% of counties lacked an in-county otolaryngologist; after accounting for adjacency to independent cities with at least one provider, 55.8% remained without local access. Non-metropolitan jurisdictions were disproportionately affected. Although 35.8% of otolaryngologists reported fellowship training, approximately 98% of fellowship-trained physicians practiced in metropolitan jurisdictions.

Otolaryngology care in Virginia remains geographically uneven, with many jurisdictions lacking local specialty access. These findings highlight gaps in access to care and may inform workforce planning and strategies to improve availability of otolaryngologic services in underserved regions.

Level IV (cross-sectional observational study).