Physician Distribution and Rural Access to Medical Services

Considers the implications of different ways of defining physician shortage in rural areas and estimates the effects of a variety of policies designed to influence physician distribution. The analysis consists of two levels. At the aggregate level, this report (1) examines both the current distribution of physicians and recent trends by relating physician-to-population ratios for various specialties to demographic and other characteristics of counties, and (2) identifies outliers (i.e., counties with substantially more or substantially fewer physicians). In the individual level analysis using survey data, the report (1) estimates the effect of policy variables on the probability of a rural practice, (2) estimates the effect of policy variables on how rural the practice location is, and (3) examines interrelationships among the policy variables. The implications of these findings are evaluated for the effectiveness of policy options such as area health education centers in rural areas, loan forgiveness, rural preceptorships, additional rural group practices, and programs to influence specialty choice.