Desired locations were a special field created in the birth origins physician database such that overlapping variables are not over counted. The individual component career and location choices that were considered desired at the national level include urban underserved, small rural, isolated rural, rural underserved, military, academic.
Major medical centers and urban served locations and large rural or micropolitan locations were not considered to be optimal. Obviously they are important for primary care training, primary care access for some populations, and service to some underserved populations, but by their choice mainly. Practicing in a major medical center with 100% of training, the most health policy support (number and highest degree), the most and best health insurance coverages, the highest population income levels, the most support, and the optimal urban lifestyle for the 70% of medical students born in such locations, is not a difficult choice. Urban served locations and rural micropolitan locations share similar characteristics. Major Medical Centers
Getting professionals of all kinds, to locate where
professionals are least likely to locate is important.
First, some background might help. It is difficult to find an FP grouping that does not contribute when considering all of the areas. Some contribute more to small rural distribution, some to urban underserved, others to military or academic areas. Optimal outcomes range from 15% to 50% for family physicians found in one or more optimal national workforce locations. This ranking includes data regarding 1997 - 2003 FP graduates in 2005 locations for ethnicity and gender and data from othe 1987 - 1999 class years of all physicians for other comparisons.
FPs Born in whole county shortage area, Native American FPs, FPs from Accelerated training programs (older, most committed to FP), FP grads of Duluth and Mercer, Puerto Rican FPs, Black FPs, Hispanic FPs Recent Black Family Physicians
Historically Black medical school grads, lowest 30% medical schools ranked by MCAT,
older graduate FPs, age 30 or more FP grads, FPs who are public medical school grads (allopathic or
The Average Optimal National Location rate for FP is 24% and increases to 27% when including past military service. The FP advantages stem from the fact that only 50% of FPs are found in major medical centers. This leaves 50% instead of 25% to distribute and serve when compared to all other physicians. The same problems are also found in Nurse Practitioners and Physicians Assistants and all physicians who are also bound to major medical centers.
specific to family medicine: Teaching at 4%, urban underserved at 5.2%, rural
underserved at 6.5%, military at 4 - 6%, small or isolated rural at 10% - no
overlapping allowed in Optimal Calculations
Average Optimal National Location rate for other physicians 12 - 18%
Divisions in Physician Career and Location Choice Related to Age at Graduation - Changes in the United States mean that physicians layer out by socioeconomics, age, and scores into three different career types: those that emphasis people, direct patient care, and generalist focus; those that those that distribute and those that do not.
Ranking Medical Schools and Programs
Physician Workforce Studies