Geographic Distribution

In the 1960s and 1970s, the federal government responded to a shortage of physicians by implementing policies and providing funding to increase the number of medical schools and their class sizes. In 1976, it was determined that the physician shortage had been alleviated and by the early 1990's experts were predicting physician surpluses.

While it can be debated what the right ratio of physicians to population is, it is clear physicians are not distributed uniformly across communities, leaving many seriously underserved. The expectation at the end of the 1960's and 1970's expansion was that competition within a free market structure would resolve these distribution problems. Yet, in 2008, geographic maldistribution of physician services persists.

Archive »Policy Briefs

Archive »Research

The Role of a Rural Medical School Campus in Developing a Sense of Place: The First 10 Years
March 2010 – Family Medicine
"Most medical schools are now increasing class size and/or start¬ing regional campuses to address the anticipated physician shortage. Maldistribution is also an issue, with only 9% of physicians prac¬ticing in rural areas where 20 % of Americans live. Previous studies have shown that rural upbringing and small-town medical training are associated with rural practice." Read More…

American Board of Family Medicine (ABFM) Maintenance of Certification: Variations in Self-Assessment Modules uptake within the 2006 Cohort
January 2010 – Journal of the American Board of Family Medicine
"In its recent shift to a Maintenance of Certification for Family Physicians (MC-FP) paradigm, the American Board of Family Medicine provides diplomates completing 3 self assessment modules (SAMs) in the first 3 years (or first stage of MC-FP) a pathway to extend their recertification cycle to 10 years provided additional requirements are met, versus a 7-year cycle for "non-completers." We use geographic information systems to report on variations in SAM participation and completion in a single cohort of diplomates followed during their first stage of MC-FP to better understand the communities impacted, barriers to uptake, and urban-rural differences." Read More…

The Impact of a Clinic Move on Vulnerable Patients with Chronic Disease: A Geographic Information Systems (GIS) Analysis
January 2010 – Journal of the American Board of Family Medicine
"Primary health care clinics are bound to the patients they serve by geography, an essential lesson rarely emphasized in preparing resident trainees for community practice.1 Policy makers promote access to a personal physician for all their constituents, and it is essential that providers understand their service areas and the impact of geography on those they serve. Residency clinics are the training ground for these skills but have traditionally lacked the tools necessary to demonstrate and contextualize caring for patients within the broader community." Read More…

Funding Growth Drives Community Health Center Services
February 2010 – Health Affairs
"Federally qualified health centers play a major role in providing health care to the underserved, and will remain an important part of the health care safety net even under reforms that will increase the number of Americans with health insurance. We show that the investments made in federally qualified health centers during 1996–2006 clearly translated into an increase in services available to patients, including mental health and substance abuse treatment and counseling and staffing." Read More…

Health Extension in New Mexico: An Academic Health Center and the Social Determinants of Disease
January 2010 – Annals of Family Medicine
"New Mexico is a large, rural, multiethnic state with the second highest uninsured rate in the nation, 30 of its 33 counties federally are designated Health Profession Shortage Areas, and 60% of the population lives in rural or frontier communities with variable access to services. The University of New Mexico (UNM) Health Sciences Center (UNMHSC) surveyed rural community health leaders on how the UNMHSC might better serve their health needs. The results were sobering." Read More…

Survey of Care for the Underserved: A Control Group Study of Practicing Physicians Who Were Graduates of The Ohio State University College of Medicine Premedical Postbaccalaureate Training Program
January 2010 – Academic Medicine
"Premedical postbaccalaureate programs (PBPs) are designed to enhance the academic readiness of students with undergraduate degrees in order to improve their chances for successful admission into and completion of medical school. PBPs that focus on preparing underrepresented minority (URM) and disadvantaged students for successful completion of medical school enhance physician workforce diversity. Historically, URM physicians have reported a greater interest in establishing practices that provide care for underserved communities." Read More…

The Doctor Can't See You Now: New York's Physician Shortage Grows
December 2009 – Healthcare Association of New York State
"Physician shortages threaten many New York residents' access to health care. While steps have been taken to begin to address this recognized problem, more state and federal action is needed to increase the number of primary care physicians, as well as physicians in other specialties that are in demand. Further, New York State must explore alternative ways to deliver care to underserved populations." Read More...

Persistent Primary Care Health Professional Areas (HPSAs) and Health Care Access in Rural America
September 2009 - WWAMI Rural Health Research Center
"This study examines the degree to which persistence of primary care HPSA designation in rural counties is associated with lower population socioeconomic status and deficiencies in access to health care services." Read More…

Care in the Country: A Historical Case Study of Long Term Sustainability in 4 Rural Health Centers
Brad Wright, American Journal of Public Health, September 2009
"The health care system in the rural United States faces many challenges. Compared with urban populations, rural residents are more likely to be low income, uninsured, and in poor health. Per capita federal spending on rural health, despite an arguably greater need for services, is not quite half that for health care nationally. Limited resources impose financial constraints on rural primary care programs that provide a large amount of uncompensated care, which in turn threatens organizational sustainability. Rural primary care programs are the sole source of health care in many communities; thus their survival is vitally important." Read More…

Does the Under- or Overrepresentation of Minority Physicians across Geographical Areas Affect the Location Decisions of Minority Physicians?
August 2009 – Health Services Research
"Racial diversity has recently been the topic of reports by the Sullivan Commission on Diversity in the Healthcare Workforce and the Institute of Medicine (Institute of Medicine 2004; Sullivan Commission 2004). These reports emphasize the importance of racial/ethnic physician–patient concordance in the provision of quality patient care." Read More..

Rural Medicine: Its Own Specialty?
Paul D. Simmons, MD FAAFP, Journal of Rural Health, Summer 2009
"The specialty of family medicine was organized in response to the specialist-heavy medical world of the 1950s. Times have changed. In some urban areas, there is no shortage of primary care physicians and mid-levels to serve the needs of most patients. However, despite one fifth of the US population living in nonmetropolitan areas, only 10% of physicians practice there. Family physicians are the specialists most likely to work in rural areas, but two thirds work in metropolitan areas with populations more than 250,000. Over the last decade, the overall trend has been downward in family medicine residency matches. The American Medical Association estimates that 16,000 more physicians are needed right now to alleviate medical needs in underserved areas. Rural medical care is in trouble, and it is time for rural medicine to become its own specialty." Read More…

Factors That Influence Physicians to Practice in Rural Locations: A Review and Commentary
Darra Ballance, MLIS AHIP et al., Journal of Rural Health, Summer 2009
"Rural populations remain underserved by physicians, despite various efforts by medical schools and other institutions/organizations to correct this disparity. We examined the literature on factors that influence rural practice location decisions by physicians to determine what opportunities exist along the entire educational pipeline to entice physicians to, and retain them in, rural areas. Results reported in the literature favor a multidisciplinary or multi-faceted approach that results in more residents and physicians locating their practices in rural areas. The need to define proven strategies is not the pressing issue; rather, the needs are to define the commitments necessary to implement proven strategies, as well as the will to make physician distribution a priority issue in medical education." Read More…

Commentary: Oversimplifying Primary Care Supply and Shortages
Gary L. Freed, MD MPH and James Stockman, MD, Journal of the American Medical Association, May 13, 2009
"Attempting to ensure an appropriate primary care workforce to meet the needs of the United States is a complex and daunting task that is vital to the ultimate health of the nation. Oversimplifying the nuances of the primary care workforce may result in policies and priorities at odds with needs. For the specialty of pediatrics, it appears that a close to appropriate proportion of trainees continues to enter the primary care arena. Certainly, an erosion of that proportion or in the absolute number of physicians entering pediatrics would require appropriate action to ensure a continued capacity to provide general and subspecialty care to children. Those concerned with workforce adequacy should continue to monitor the situation closely." Read More…

Are There Enough Doctors in my Community? Perceptions of the Local Physician Supply
Holly Biola, MD MPH, and Donald Pathman, MD MPH, Journal of Rural Health, Spring 2009
"Although physician numbers have increased in counties of all sizes and types over the past 40 years, the imbalance in physician supply between rural and urban areas has also increased. In response to this ongoing disparity, a variety of government programs use incentives to attract physicians to rural shortage areas, offering enticements such as educational loan repayment support and bonus payments for Medicare services. These programs target their resources to communities that have earned official shortage area designations, which are principally based on calculated physician-to-population (PtP) ratios. The assumption, at least implicitly, is that if PtP ratios can be made uniform across communities, then the rural-urban physician maldistribution problem will be solved." Read More…

Do International Medical Graduates (IMGs) "Fill the Gap" in Rural Primary Care in the United States? A National Study
Matthew J. Thompson, MBChB DPhil, et al., Journal of Rural Health, Spring 2009
"Almost 1 in 4 (23%) physicians currently practicing in the United States are international medical graduates (IMGs). The contribution that IMGs make to the medical workforce in the United States has been the focus of intense debate, in particular whether they make up for physician deficits in certain specialties or geographic locations. The presence and extent of this "gap filling" has profound implications for planning the future medical workforce. For example, if IMGs do indeed fill essential gaps in the medical workforce, then any policies to reduce their entry into the United States (such as capping the number of federally funded residency positions) could have deleterious effects on access to medical care, unless they are replaced by an increased output from US medical schools. In contrast, if IMGs simply add to an oversupply of physicians that is poorly distributed among geographic locations and specialties, then reducing IMG numbers may have relatively little negative impact, so long as these maldistributions are addressed by other initiatives such as expanding the National Health Service Corps (NHSC), or support for service initiatives (eg, loan repayment)." Read More…

Perspectives on Rural Health Workforce Issues: Illinois-Arkansas Comparison
Martin MacDowell, DrPH, et al., Journal of Rural Health, Spring 2009
"Among rural counties in the United States, 65% lack adequate numbers of health professionals with the distribution of physicians favoring urban areas. Rural areas have significant shortages, rural residents are more dependent on public assistance programs, and rural residents must travel farther to see a physician compared with their urban counterparts. Physician specialists are not as plentiful as primary care physicians in rural settings. Overall, recruitment and retention of rural health care professionals remains difficult." Read More…

Community Dimensions and HPSA Practice Location: 30 Years of Family Medicine Training
Suzanne B. Cashman, ScD et al., Family Medicine - April 2009
"In 1996, the Institute of Medicine revised the definition of primary care to include "the community context of medical practice." Shortly after, as a way to move beyond the general sentiment that community should factor into a physician's work, Pathman et al identi¬fied and defined four distinct categories of activities (sociocultural aspects of patient care, use of commu¬nity health resources, community-oriented primary care, and community participation and assimilation) through which physicians engage with communities. This framed much of the last decade's discussion about and exploration into physicians' community involvement." Read More…

A Comprehensive Medical Education Program Response to Rural Primary Care Needs
Michael Glasser, PhD et al., Academic Medicine, October 2008
"This article presents the characteristics and results of the Rural Medical Education (RMED) Program which addresses medical workforce needs focused on reducing rural health disparities. The program is comprehensive in implementing a system of recruitment of candidates from rural backgrounds, offering a rural-focused curriculum, and instituting evaluative components to track outcomes." Read More...

The Diffusion of Physicians
Thomas C. Ricketts and Randy Randolph, Health Affairs, September/October 2008
"Physicians move from place to place over their careers; this is thought to reflect the economic theory that they seek better opportunities to practice. Using national data, this study tracked physician movement between counties classified by physician-to-population ratio and socioeconomic characteristics. Approximately one-quarter of practicing physicians moved in each of two ten-year periods, 1981–1991 and 1991–2001. The overall tendency of movers was to go to places with lower physician-to-population ratios but higher per capita incomes and lower unemployment. These trends, if they continue, may help decrease access to physician care in rural and urban underserved areas." Read More...

Rural-Urban Differences in Primary Care Physicians' Practice Patterns, Characteristics and Incomes
William B. Weeks, MD, MS and Amy E. Wallace, MD, MPH, Journal of Rural Health, Spring 2008
"Low salaries and difficult work conditions are perceived as a major barrier to the recruitment of primary care physicians to rural settings." Read More...

Archive »Reports

County Health Rankings
February 17, 2010 – Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute
"The County Health Rankings—the first set of reports to rank the overall health of every county in all 50 states—were released today by the University of Wisconsin's Population Health Institute and the Robert Wood Johnson Foundation at a briefing in Washington, D.C and on www.countyhealthrankings.org. The 50 state reports help public health and community leaders, policy-makers, consumers and others to see how healthy their county is, compare it with others within their state and find ways to improve the health of their community." Read More…

The Economic Stimulus: Gauging the Early Effects of ARRA Funding on Health Centers and Medically Underserved Populations and Communities
February 16, 2010 – The George Washington University and RCHN Community Health Foundation
"During times of economic crisis, community health centers and other health care safety net providers become even more vital to the communities they serve. The current downturn, with its high levels of unemployment and enormous impact on family incomes, carries major implications for health insurance coverage." Read More…

Striving Toward Excellence: Faculty Diversity in Medical Education
November 2009 – Association of American Medical Colleges
"The Association of American Medical Colleges' (AAMC) report, 'Striving Toward Excellence: Faculty Diversity in Medical Education,' presents an evolutionary paradigm to increase and support faculty diversity that calls on learning institutions "to develop programs not based solely on the current lack of diversity but rather to eradicate inhibitors of institutional excellence." Read More…

Rural Health Care Workforce: Opportunities to Improve Care Delivery
Center for Rural Affairs - August 2009
"Today the Center for Rural Affairs released a report entitled, Rural Health Care Workforce: Opportunities to Improve Care Delivery. The report examines the critical shortage of primary care providers in rural America, the importance of nurse practitioners as rural primary care providers, opportunities for rural nursing, and ultimately, how health care reform presents opportunities for nurses to improve access to and quality of health care for rural residents."
To read the news release, click here.
To read the report, click here.

Access to and Affordability of Care in Massachusetts as of Fall 2008: Geographic and Racial/Ethnic Differences
The Urban Institute - May 2009
"Massachusetts continues to move forward on comprehensive health reform, with improvements in coverage, access to care and the affordability of care in the state. This policy brief provides a supplement to a recent Health Affairs article on health reform in Massachusetts, examining geographic and racial/ethnic differences in access to care and affordability of care across the commonwealth in Fall 2008." Read More…

Hard Times in the Heart Land: Health Care in Rural America
U.S. Department of Health and Human Services - May 2009
"Throughout rural America, there are nearly 50 million people who face challenges in accessing health care. The past several decades have consistently shown higher rates of poverty, mortality, uninsurance, and limited access to a primary health care provider in rural areas. With the recent economic downturn, there is potential for an increase in many of the health disparities and access concerns that are already elevated in rural communities. Hard Times in the Heartland provides insight into the current state of health care in rural areas and the critical need for health care reform." Read More…

The Northern Ontario School of Medicine: Responding to the Needs of the People and Communities of Northern Ontario
Education for Health - December 2008
Northern Ontario, like many rural and remote regions around the world, has a chronic shortage of health professionals. Recognizing that medical graduates who have grown up in rural areas are more likely to practice in rural settings, the Government of Ontario, Canada established a new medical school with a social accountability mandate to contribute to improving the health of the peoples and communities of Northern Ontario." Read More…

New Mexico Residents Struggle to Navigate Health Care System in Crisis
PBS News Hour with Jim Lehrer, October 15, 2008
"The health professional shortage in New Mexico is acute. Primary care physicians are on call 24 hours a day, seven days a week in a small community. They may not have anybody who can substitute for them." Read More...

"Many Underserved Areas Lack a Health Center Site, and the Health Center Program Needs More Oversight"
Government Accountability Office, August 2008
"Health centers funded through grants under the Health Center Program—managed by the Health Resources and Services Administration (HRSA), an agency in the U.S. Department of Health and Human Services (HHS)—provide comprehensive primary care services for the medically underserved. Grant awards for new health center sites in 2007 reduced the overall percentage of MUAs lacking a health center site from 47 percent in 2006 to 43 percent in 2007. In addition, GAO found wide geographic variation in the percentage of MUAs that lacked a health center site in both years." Read More...

Archive »In Legislation/On The Hill

President Obama Announces Recovery Act Awards to Build, Renovate, Community Health Centers in More Than 30 States
December 9, 2009 – Washington, DC

Secretary Sebelius Releases $7.6 Million in Recovery Act Funds to Support Health Professionals Serving in High Need Areas
September 30, 2009 – Washington, D.C.

Top Obama Administration Officials Hold Rural Health Community Forum
July 20, 2009 – Business Wire and United States Department of Agriculture Newsroom
"Four Cabinet Secretaries hosted a rural health community forum today in St. John Parish, La., to share information about the federal government's efforts to rebuild and revitalize rural America." Read More…

Sibelius Makes Recovery Act Funding Available to Expand Health Professions Training
July 28, 2009 – Washington, D.C.
"HHS Secretary Kathleen Sebelius today announced the availability of $200 million to support grants, loans, loan repayment, and scholarships to expand the training of health care professionals. The funds are expected to train approximately 8,000 students and credentialed health professionals by the end of fiscal year 2010. Today's funds are part of the $500 million allotted to HHS' Health Resources and Services Administration (HRSA), to address workforce shortages under the American Recovery and Reinvestment Act (ARRA)." Read More…

Senate Introduces Rural Physician Pipeline Act of 2009 (S. 1628)
August 6, 2009 – Washington, D.C.
On August 6, 2009, Senator Mark Udall (D-CO) introduced the Rural Physician Pipeline Act of 2009.

House and Senate Introduce Rural Veterans Health Care Improvement Act of 2009
July 1, 2009 – Washington, D.C.
The House recently introduced a bill that will give rural veterans better access health care and services, and is a companion bill to the Senate version introduced in March. The House version (H.R. 2879) was introduced by Ann Kirkpatrick (D-AZ) and the Senate Version (S. 658) was introduced by Jon Tester (D-MT).
To read the House bill, click here.
To read the Senate bill, click here.

House Introduces the Access to Frontline Health Care Act of 2009
June 16, 2009 – Washington, D.C.
On June 16, Bruce Braley (D-IA) introduced H.R. 2891, the Access to Frontline Health Care Act of 2009. The bill will create a new loan repayment program, help place health care personnel in underserved areas, and allow flexibility for States to help bring health care providers to specific areas of need. Read More…

Secretary Sebelius Makes Recovery Act Funding Available to Bolster Health Care in Needy Communities, Relieve Providers' Student Debt
June 5, 2009 - Washington, D.C.
"HHS Secretary Kathleen Sebelius today announced the availability of nearly $200 million from the American Recovery and Reinvestment Act to support student loan repayments for primary care medical, dental and mental health clinicians who want to work at National Health Service Corps (NHSC) sites. In exchange for the loan repayments, clinicians serve for two years with the Corps. The new funds are expected to double the number of Corps clinicians and make 3,300 awards to clinicians that serve in health centers, rural health clinics and other health care facilities that care for uninsured and underserved people. " Read More…

North Dakota Senator Introduces Rural Health Bill
May 21, 2009 – Washington, D.C.
On May 21, 2009, Senator Kent Conrad (D-ND) introduced the Craig Thomas Rural Hospital and Provider Equity Act of 2009. Read More…

Senate HELP Committee Holds Hearing on Primary Health Care Access Reform: Community Health Centers and the National Health Service Corps
April 30, 2009 - Washington, D.C.
The Senate HELP Committee held a hearing on reforming access to primary health care. Witnesses included Fitzhugh Mullan, Dan Hawkins, Cynthia Baschetta and others. To read the statements of the witnesses, or to watch a video of the hearing, click here.

House Majority Whip Clyburn Introduces Bill To Quadruple Number of Community Health Centers in U.S.
February 27, 2009 – Washington, D.C.
House Majority Whip Jim Clyburn (D-SD) introduced a $26 billion bill to quadruple the number of community health centers that now treat 16 million uninsured and low-income Americans, including 300,000 in South Carolina. Senator Bernie Sanders (D-VT) introduced a similar bill (S. 486) in the Senate.
To read H.R. 1296, click here.
To read S. 486, click here.

House Energy and Commerce Subcommittee on Health holds hearing on Access to Health Care
March 24, 2009 - Washington, D.C.
The House Energy and Commerce Subcommittee on Health held a hearing on "Making Health Care Work for American Families: Improving Access to Care". Witnesses included Dr. Fitzhugh Mullan, Dr. Brian Smedley, Dr. John Kitchell, Dr. Michael Sitorius, Dr. Lavizzo-Mourey, Dr. Jeffrey Harris, Dr. James Bean, and Dr. Diane Rowland.
To read the witness testimonies and listen to an audio recording of the hearing, click here.

House passes H.R. 2583
September 23, 2008 Washingtron, D.C. - On September 23, 2008, the House passed by a voice vote HR 2583. The bill would provide $44.2 million from FY 2010 to FY 2014 to provide loans to public and not-for-profit hospitals to create residency training programs for physicians. The bill specifies preference for training programs in family medicine, internal medicine, emergency medicine and hospitals in rural areas or small cities. Read More...

Archive »News

Program to Help Remedy Shortage of Rural Doctors
April 19, 2010 – Louisville Courier-Journal
"Doctor shortages are a long-standing problem in largely rural Kentucky, and some experts say the situation may continue to worsen as tens of thousands of additional Kentuckians become insured under health care reform." Read More…

Rural Health Risk Factor: A Shortage of Doctors
March 6, 2010 – Wisconsin State Journal
"There are one-fourth fewer doctors per person in rural areas than in urban areas, and half as many specialists, according to the U.S. Department of Health and Human Services. That means people often must wait for primary care and travel to cities for specialty care - even for services such as chemotherapy that involve several visits a month." Read More…

Kansas Program Targets Rural Students
February 25, 2010 – The Abeline Reflector-Chronicle
Once they've seen the lights of the big city, it's hard to get medical students back to the farm. Each year, the Kansas Scholars in Rural Health program, administered by the University of Kansas School of Medicine in Wichita, selects up to 14 college juniors from rural areas who intend to become physicians in a primary care field, such as family medicine, internal medicine or general pediatrics and then practice in rural Kansas areas." Read More…

UMD Hosts a Rural Pre-Med Workshop
February 12, 2010 – WDIO.com

A Plan to Help Places Hurting for Doctors
February 16, 2010 – Detroit Free Press
"With a statewide shortage of primary care doctors, particularly in urban areas such as Detroit, Michigan needs more physicians. Michigan has launched a program that offers grants to primary care doctors who work in shortage areas, and help to repay medical school loans. Michigan also hopes to tap into federal incentives to improve doctor practices, and to coordinate and improve care by assigning each uninsured patient to a single doctor." Read More…

Medicare Doctors Waning in Rural Arizona
January 24, 2010 – The Arizona Republic
"At the Prescott Valley Primary and Urgent Care Clinic, Tom White made his way past a woman wearing neck and knee braces and an elderly man sniffling and coughing. Urgent-care centers often are frequented by people who need quick access to medical help. They have a sprain. They have the flu. But for White, 72, the bustling clinic is where he goes for his primary health care." Read More…

Program Will Groom Students into Rural Doctors
January 20, 2010 – Kearneyhub.com
"The University of Nebraska at Kearney wants to increase the number of physicians in rural Nebraska. UNK entered an agreement with the University of Nebraska Medical Center to establish the Kearney Health Opportunities Program." Read More…

No Country for Health Care, Part 3: The Shrinking Rural Ranks
January 6, 2010 – The Texas Tribune
Politically speaking, it's no time to be an advocate for rural health care. In the last House Speaker's race, and on the state's health care regulatory boards, rural lawmakers say they've been outnumbered and under-represented. The looming redistricting battle will only shrink their ranks. They're finding it more and more difficult to teach an increasingly urban Legislature about the crisis in rural health care." Read More…

No Country for Health Care, Part 1: Far From Care
January 4, 2010 – The Texas Tribune
"Dozens of rural Texas counties have no primary care doctors, no hospitals, no pharmacies. Many Texans live more than an hour from basic medical care. Some border communities have so little health care that U.S. citizens cross over into Mexico to get it. It's a void medical experts say contributes to poor health and even death, as rural residents succumb to preventative diseases that they don't have the doctors, money, or transportation to treat." Read More…

Physicians in Short Supply in Rural Missouri
January 5, 2010 – Columbia Missourian
"Gravel roads, small towns and rows of corn that go on for miles — these are images of rural Missouri. More often than not, doctors are missing from that picture. Eighty percent of Missouri's counties don't have enough physicians. Many of those counties are rural." Read More…

The Only Doctor in Town
December 5, 2009 – Washington Post
"Practicing family medicine in a place like Post puts Edwards in the minority, a fact that is not lost on policymakers in Washington. A physician shortage has long plagued rural areas. Young doctors saddled with medical school debt are more often drawn to such lucrative specialties as radiology or anesthesiology in big cities or suburban areas, where they can earn double the $120,000 to $140,000 salary of a rural family practitioner." Read More…

Overburdened Rural Doctors Provide a Lifeline for the Isolated
December 6, 2009 – Dallasnews.com
"Dr. David Fedro steers his van packed with medical supplies over potholed streets. He passes a cemetery and rolling pastures, venturing miles from his clinic in Marlin. Many of his patients are too frail to make the trip into town. Twice a week, he makes house calls with his nurse, like country doctors of old. Fedro and his colleagues, Dr. J. Scott Crockett and Dr. Dileep Bhateley, are the only full-time doctors in Falls County." Read More…

Medical Schools, Programs Help Rural Students Become Doctors in Rural Areas
December 6, 2009 – Thetowntalk.com
"The Central Louisiana Area Health Education Center hopes they'll return to those small towns after medical school. To reach this goal, the four AHECs in Louisiana partner with LSU Health Sciences Center to help identify and select pre-med college students from small towns for special activities to help them." Read More…

Caring for Communities: Providers Bring Good Medicine to Small-Town America
American Profile, September 3, 2009
"About 50 million Americans live in areas without access to basic medical and dental care, according to the National Health Service Corps (NHSC), which Congress established in 1970 to recruit health care professionals to medically underserved areas. To remedy this disparity, the NHSC provides scholarships and forgives loans to primary care physicians, physician assistants, nurse practitioners, dentists, certified midwives, mental health professionals and dental hygienists in exchange for at least two years of work in those settings." Read More…

As Nation Discusses Health Care, Texas Doctor Shortage Expected to Worsen
Statesman, September 6, 2009
"As talk on national health care reform centers on providing insurance for everyone, Texas and the nation are already struggling with a shortage of primary care doctors that is expected to keep growing. In Texas, 114 of the 254 counties have been designated by the federal government as primary-care shortage areas. Some clinics spend months trying to lure doctors, and some patients drive one or two counties away for even the most routine health care." Read More…

Shortage of Rural Health Care Workforce Hits Rural America Hard
Center for Rural Affairs, September 2009
"Rural America faces a critical shortage of primary care providers, jeopardizing the nation's ability to meet the health care needs of the rural population. Primary care providers offer routine care, health promotion and disease prevention, and treat chronic conditions - all fundamental needs of the rural population." Read More…

Perry Signs Bill to Lure More Doctors to Rural Areas
Amarillo News - June 18, 2009
"Dozens of rural counties in West Texas suffering a doctor shortage - especially 27 that do not have even one physician - got some welcome news Wednesday. Gov. Rick Perry signed House Bill 2154, which will help 114 medically underserved counties lure as many as 900 new doctors." Read More…

Parma Health Ministry Free Clinic Turns Away Newly Uninsured Patients Away for Lack of Doctors
Plain Dealer Reporter - June 18, 2009
"Deborah Hannan dreads picking up the phone at Parma Health Ministry. Since March, the free clinic, which has only two volunteer primary care physicians who see patients in the evenings, has had to turn people away. Hannan fields about a half-dozen calls a day, mostly from the recently uninsured. All she can do is add their names to the ever-growing waiting list or refer them elsewhere." Read More…

Rural Areas Struggle to Provide Care
Abeline Reporter - June 13, 2009
"Health care experts have coined the term 'medically disenfranchised' to describe the more than 60 million Americans who lack regular care. In many rural Big Country communities, gaps in care are being plugged by a patchwork of charitable and for-profit health clinics." Read More…

Underserved or Just Undercounted?
Ventura County Star - May 17, 2009
"Thousands of Ventura County residents may not be getting proper healthcare because they don't have access to a family doctor. The shortage is almost certain to grow worse because a number of primary care physicians are getting closer to retirement and fewer medical school graduates are choosing to practice family medicine." Read More…

Rural Minnesota Clinics, Hospitals Struggle for New Doctors
Grand Forks Herald - May 10, 2009
"A growing shortage of rural physicians is taking its toll, and patients are feeling the crunch: Longer waits for non-emergency appointments. More care delegated to mid-level practitioners. Primary care physicians refusing to take on new patients. A number of factors have contributed to the shortage: Fewer medical students opting for primary care, challenges with reimbursement, the rising cost of medical school, and the lifestyle goals of a new generation of physicians." Read More…

Physician Distribution: An Old Problem Receives New Attention
Medscape News - May 14, 2009
"From President Obama, to members of Congress, to federal and private agencies concerned with the issue, officials in Washington and beyond are pointing to the need for more physicians and other healthcare workers, especially in primary care. But as essential as it is, the push for more physicians and healthcare professionals will not by itself solve a related workforce problem: the maldistribution of physicians and other healthcare professionals across the nation, a problem that has left rural, frontier, and some inner-city communities especially vulnerable." Read More…

Doctor Shortage in Rural Minnesota Reaches Crisis
Minnesota Public Radio - May 18, 2009
"Rural Minnesota has 13 percent of the state's population, but only 5 percent of all Minnesota physicians practice there, according to the Minnesota Hospital Association. With a wave of doctors nearing retirement, things are likely to get worse. For patients, the shortage means longer waits to get medical attention. The most critical need is for doctors who practice family medicine." Read More…

Need For Rural Doctors Critical
Lawrence Journal World & News - May 11, 2009
"Wanted: rural Kansas doctors. 'There's a need nationwide for primary care, and it's only exacerbated — made worse in rural and underserved areas, and Kansas is a state that is mostly rural and has some real problems,' said Dr. Heidi Chumley, senior associate dean for medical education at Kansas University Medical Center." Read More…

Rural Doctor Shortage Called a "Crisis" in Washington
The Seattle Times - April 18, 2009
"Rural areas in Washington and elsewhere are facing a shortage of physicians — and the problem is getting worse. Even as the population of older people and ethnic minorities continues to grow in those communities, the shortage is worsening as many current rural doctors reach retirement age and fewer available candidates emerge from U.S. medical schools." Read More…

Doctors from Afar Meeting Rural Oregon's Needs
The Oregonian - April 17, 2009
"Across rural Oregon, more people travel long distances to see a doctor, or wait weeks or months for appointments. It takes as long as two years for some health centers to recruit a single physician, because many want to work for better pay in metropolitan areas. The remedy to this crisis comes from India, the Philippines, Canada, Syria, Pakistan and more than 20 other far-flung nations." Read More…

Doctor Shortage Looms In Wisconsin: Demand For Primary Care Doctors May Go Up By 65 Percent By 2030
Madison News - April 6, 2009
"The Wisconsin Council on Medical Education and Workforce said the greatest need is for doctors specializing in family practice, internal medicine, and hospitalists. In other words, doctors serving as primary-care physicians. The report also predicts that demand for primary-care doctors will increase by 33 percent by the year 2020 and as much as 65 percent by the year 2030." Read More…

Doctor Shortages Hit Maryland
Frederick News Post - April 5, 2009
"The Maryland Hospital Association commissioned a study on the doctor shortage last year, the most rigorous ever performed in the area, according to association spokeswoman Nancy Fiedler. After adjusting for part-time and full-time status and the amount of time dedicated to seeing patients, the study found Maryland has the equivalent of 178 active physicians per 100,000 residents. The U.S. average is 212 per 100,000. Using guidelines from several sources, including the National Ambulatory Medical Care Survey and the Graduate Medical Education National Advisory Council, the study found that Western Maryland has a shortage in primary care and 19 of 28 identified specialties. The study predicts this shortage will expand to 21 specialties by 2015." Read More…

Waxman Wants Universal Coverage But More Doctors Too
CQ Healthbeat - March 24, 2009
"House Energy and Commerce Committee Chairman Henry Waxman said Tuesday that a congressional overhaul of the health care system must not only provide for universal coverage but also for more primary care doctors and nurses to ensure that an insurance card actually gives the holder access to treatment. Witnesses at the hearing suggested various approaches to improving access, ranging from sharply increasing the supply of primary care physicians and nurses, to strengthening Medicaid to addressing racial, ethnic and geographic disparities in access to care. GOP lawmakers stressed the need to increase the supply of doctors by revisions to the medical malpractice system they said have left certain parts of the country without access to specialists." Read More…

Proposed Bill Would Increase Number of Health-Care Professionals in Underserved Areas
The Daily Texan - March 24, 2009
"At a press conference in the state Capitol Monday, Rep. Warren Chisum, R-Pampa, said a proposed bill would help increase the number of primary-care physicians, dentists and other health-care professionals in underserved areas of Texas. The bill would create the Texas Health Care Access Fund, which would pay for up to $160,000 of medical-school debt after four years of work in a shortage area." Read More…

Doctors in Short Supply in Rural Maryland
Baltimore Sun - March 1, 2009
"There are not enough primary-care doctors setting up practice…leaving some residents without access to basic health care and leading to more costly and serious illnesses, doctors say. Those doctors - and many specialists - are reluctant to leave the city for the country, where they typically get paid less, work more and find fewer job opportunities for their spouses, who aren't always ready to give up the trappings of life near an urban area. Lawmakers - who worked on two task forces last year that looked at different parts of the issue - are considering both short- and long-term fixes. Solutions could include a loan forgiveness program for primary-care doctors and specialists in rural areas who agree to remain in those communities for a certain number of years." Read More…

Medical Education Futures Study

George Washington University School of Public Health and Health Services

Josiah Macy Jr. Foundation