Distribution of Physicians

Robert C. Bowman, M.D.

Medical schools by alpha order

Physician Distribution in the United States - to understand what we have done and what we could do

Ranking Medical Schools and FP Residency Programs

Distribution by Income Levels  and Admissions By Income Quartiles - When income goes up, admissions goes up, major medical center location goes up, and distribution to rural and underserved areas goes down and so does choice of family medicine

Schools with higher MCAT have lower FP, rural, poverty choices and increased research choice.

No school successful in rural or in poverty distribution is able to succeed without increasing family medicine choice. Older, lower income, rural born, and instate born students have increased choice of family medicine and these categories of students also have increased retention within the state that invested in them in education and medical education.

MCAT data from medical school, advisor, and faculty web sites and sources. The highest and lowest MCAT scores may well have the greatest variability and this should be considered.

Distribution Table by individual medical school (tables take some time)

Osteopathic family medicine choice is much higher than match figures, this family medicine data is from the most recent Family Medicine issue and represents the latest data, not 1987-2000

Research choice does not peak for 25 years but the 1987-1994 data is consistent with eventual research choice by school

Other Physician Workforce Studies

Distribution and Physician Specialties

Practice Location

US Population 1998

1987 - 2000 FPGP

1987 - 2000 Office Based Primary Care Not FPGP

1987 - 2000 Not Office Based Primary Care

Accelerated FP Programs

Urban

77.6 %

73.9 %

89.6 %

90.3 %

50 %

Large Rural

9.3 %

10.5 %

5.9  %

5.4 %

16.5 %

Medium Rural

6.9 %

9.7 %

2.7  %

2.0 %

23.7 %

Isolated Rural

6.1 %

4.8 %

0.9  %

0.7%

9.4 %

Accelerated and Rural Training Track programs have had the best rural distributions, but accelerated programs have been terminated by accrediting bodies, the lack of enough FP candidates has reduced choice of RTT, rural GME positions continue to be funded at lower levels, decreasing from 92 to 78 positions in 2005 despite rhetoric regarding rural as a priority.

See Birth Origins and Distribution Tables for comprehensive listing of needed primary care and psychiatry and poverty choices related to student characteristics, medical school characteristics, and choice of family medicine

Family Medicine Distribution by Ethnicity and Gender

  rural by RUCA rural by nonmetro Poverty Level Zip at 20% CHC Zip Rural Zip Poverty Level Zip at 18% Military Zip Core Metro Born Lesser Metro Born NonMetro Born Residency to practice Less than 60 miles Residency to Practice over 500 miles
White Female 23.7% 21.4% 23.7% 17.1% 23.7% 27.7% 4.0% 43.3% 35.3% 21.4% 54.9% 26.5%
White Male 28.3% 27.6% 20.9% 13.7% 28.3% 24.7% 8.4% 33.8% 38.6% 27.6% 47.7% 29.6%
Black Female 10.0% 9.3% 30.3% 14.0% 10.0% 36.0% 2.8% 61.1% 29.6% 9.3% 60.7% 26.1%
Black Male 11.7% 9.4% 32.5% 16.9% 11.7% 38.6% 7.1% 57.8% 32.8% 9.4% 57.5% 28.2%
Mex Am Female 9.3% 6.2% 46.4% 31.8% 9.3% 49.6% 2.5% 64.9% 28.9% 6.2% 65.5% 23.3%
Mex Am Male 14.6% 12.6% 37.3% 27.6% 14.6% 40.8% 3.7% 59.2% 28.2% 12.6% 59.3% 21.6%
Asian Female 7.7% 7.3% 27.7% 20.0% 7.7% 31.4% 2.6% 69.8% 22.9% 7.3% 58.5% 29.9%
Asian Male 7.6% 7.5% 25.4% 17.9% 7.6% 28.8% 6.8% 70.6% 21.8% 7.5% 54.4% 31.6%
PR Female         8.2% 48.0% 6.8% 62.5% 25.0% 12.5% 67.4% 26.1%
PR Male         9.4% 53.1% 5.7% 28.6% 52.4% 19.0% 60.0% 31.4%
Oth Hisp Female 13.2% 12.2% 29.3% 21.1% 13.2% 30.1% 0.0% 64.9% 23.0% 12.2% 57.4% 23.5%
Other Hisp Male 9.2% 11.5% 33.0% 18.4% 9.2% 34.0% 2.8% 59.4% 29.2% 11.5% 47.2% 37.1%
Native Female 46.7% 40.7% 44.8% 18.5% 46.7% 48.3% 0.0% 33.3% 25.9% 40.7% 42.9% 17.9%
Native Male 36.4% 31.4% 47.6% 30.2% 36.4% 50.0% 4.5% 31.4% 37.1% 31.4% 45.7% 28.6%
Other Female 17.6% 16.3% 30.5% 19.9% 17.6% 34.6% 3.6% 51.7% 32.0% 16.3% 58.4% 25.7%
Other Male 25.3% 26.0% 28.8% 18.2% 25.3% 32.6% 6.5% 35.4% 38.6% 26.0% 51.6% 28.2%
Total 22.4% 21.3% 24.9% 16.4% 22.4% 28.8% 5.9% 43.9% 34.8% 21.3% 52.9% 28.0%

Males are more likely to be married and not surprisingly are more likely to be involved in military FP programs. Black males and rural males are likely to be military, black and Mexican American females to academic programs, and therefore those most likely to distribute where needed are taken out of circulation by current health policy and failure to enter enough distributional type students into the pipeline to meet all of  the critical needs of the nation.

Asian FPs are the most likely to live in counties over 1 million after graduation while white males and natives share the lowest core urban distribution in the low 30% level.

Family physicians are more likely to be retained near their residency location and within the state of their medical school.

Physician Distribution in the United States

Accelerated Family Medicine Training Programs

Distribution Theory

Birth Origins and FP Choice

Newer Allopathic Medical Schools

Distributional Medical Schools: The Lost Lesson of Specific Forms of Government Support

Distribution: The 70-30 Distributions That Complicate Physician Distribution

Physician Distribution by Income Quintile Levels

The One Per Cent Solutions that Resolve Distribution Problems

Medical School Type and Distribution: Initial Database Description and Rural Application Graphics

Comparing Physician Distribution and the MCAT

Attrition Rates

Understanding Poverty and Physician Workforce

Urban-Rural Location, Per Capita Income, and Choice of Family Medicine

Ethnicity Gender and Rural Practice Choice

Workforce Issues - many different links here

www.ruralmedicaleducation.org

 

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