Robert C. Bowman, M.D.
Physicians in the 2005 OfficeMax version of the American Medical Association Masterfile were categorized by birth in a county or a city with a medical school, by medical school type, by career choice, and by practice location. The 1987 1999 class years represent the most recent 40% of the active United States physician workforce in near equilibrium career choices and practice locations. These are not best case, first location, or special program reports.
|
Type of Medical School |
Born in a City or County with a Medical School |
Total |
Family Medicine |
Zip Code Practice Locations |
||
|
Rural (RUCA) |
Underserved (Poverty 20%, Designated) |
Major Medical Center (75+ physicians) |
||||
|
Allopathic Private (29.7%) |
No 25.6% |
18613 |
11.5% |
11.2% |
6.3% |
70.3% |
|
Yes 74.4% |
54094 |
7.8% |
6.3% |
4.5% |
76.1% |
|
|
No City Listed 3.4% |
2579 |
8.6% |
5.1% |
5.7% |
71.6% |
|
|
Allopathic Public (50.6%) |
No 37.8% |
47395 |
19.6% |
17.7% |
8.9% |
63.2% |
|
Yes 62.2% |
78065 |
13.7% |
10.2% |
6.3% |
70.1% |
|
|
No City Listed 2.2% |
2881 |
12.1% |
9.2% |
6.6% |
69.4% |
|
|
Osteopathic Private (6.4%) |
No 36.0% |
3581 |
35.5% |
24.6% |
10.0% |
48.4% |
|
Yes 64.0% |
6378 |
28.6% |
14.3% |
7.1% |
56.2% |
|
|
No City Listed 38.5% |
6242 |
30.5% |
16.8% |
8.9% |
54.1% |
|
|
Osteopathic Public (2.5%) |
No 33.7% |
1702 |
35.5% |
27.7% |
14.5% |
47.6% |
|
Yes 56.3% |
2190 |
30.2% |
19.2% |
11.4% |
51.6% |
|
|
No City Listed 38.6% |
2443 |
29.0% |
22.3% |
12.4% |
52.1% |
|
|
North American (3.9%) |
No 26.4% |
1203 |
22.4% |
12.0% |
12.9% |
42.4% |
|
Yes 73.6% |
3355 |
15.6% |
8.5% |
7.7% |
52.5% |
|
|
No City Listed 53.4% |
5228 |
14.2% |
6.3% |
8.4% |
58.3% |
|
|
Distant International (21.0%) |
No 24.2% |
4588 |
7.9% |
10.8% |
9.5% |
68.8% |
|
Yes 75.8% |
14359 |
6.6% |
10.2% |
9.3% |
70.3% |
|
|
No City Listed 64.4% |
34262 |
8.3% |
8.3% |
7.1% |
77.0% |
|
|
Caribbean (2.0%) |
No 29.4% |
712 |
27.2% |
20.4% |
12.9% |
50.3% |
|
Yes 70.6% |
1707 |
18.9% |
11.4% |
6.9% |
62.7% |
|
|
No City Listed 52.6% |
2679 |
16.4% |
9.0% |
7.2% |
67.2% |
|
|
All (100%) |
National Averages |
|
14% |
11% |
7% |
70% |
Consistent themes are supported by the findings.
· The physicians born in counties or cities with medical schools were consistently more likely to be found in major medical center locations and were less likely to be found in rural or underserved locations or family medicine. Family medicine choice is consistently related to rural and underserved location, birth in a city or county without a medical school, and increased rates of location outside of major medical centers.
· The youngest physicians at graduation, those born in other nations, Asian origin, most urban origin, and highest income origin physicians have the lowest levels of physician distribution outside of major medical centers.
· The most elite medical schools admit the most exclusive types of students (origins, scores, colleges) that distribute at the lowest levels.
· Public schools and osteopathic schools provide significant opportunity for those with less exclusive origins.
If United States governments are educated regarding the relationships between admissions of those most like those in need of health care and better distribution to the populations in most need of health care then they can monitor and influence admissions and the paths to admission more closely. However the nation divides into states and cities that distribute education, income, and physicians while others do not. It is likely that some governments and medical schools will use birth origin and other studies to improve distributions of resources while others will ignore such studies and continue in their current maldistributions. Sadly these are also states that take education, income, and health professional resources from other states and nations in the world that have greater need rather than making investments in the children within their own jurisdictions. They also have the highest costs of health care, the greatest costs in education, and the worst outcomes in both areas. These are all choices made or influenced by governments.
For info on the databases, sharing research, or ideas - rbowman@unmc.edu