The Changing Geographic Distribution of Board-Certified Physicians

Facts, Theory, and Implications

by William B. Schwartz, Joseph P. Newhouse, Bruce W. Bennett, Albert P. Williams

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This is a study of the recent distribution of board-certified specialists among cities and towns of different sizes. Between 1960 and 1977 diplomates of the eight specialty boards that were studied appeared for the first time in many small nonmetropolitan towns. The percentage increase in numbers of specialists in small towns significantly exceeded that in cities, but the absolute increase in specialists per 100,000 persons was greater in metropolitan areas. The findings suggest that the increased supply of specialists activated market forces that caused the observed changes in distribution. It is also possible that a new preference for small-town living has contributed to this evolving pattern. If an increase in physician supply has been the major force responsible for the movement into nonmetropolitan areas, this trend implies that smaller and smaller towns will acquire board-certified specialists as the number of physicians increases.

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