Data Illustrate Geographic Dispersal of Family Physicians, Other Primary Care Professionals

Family physicians are the most likely of any physician specialty or subspecialty to practice in rural areas and the most likely to be geographically distributed in the same proportion as the U.S. population, according to a one-page fact sheet published by the Agency for Healthcare Research and Quality (AHRQ) on Feb. 3.

The data, which are based on research by the AAFP's Robert Graham Center for Policy Studies in Family Medicine and Primary Care, found that 22.5 percent of family physicians practice in rural areas, compared with 9.7 percent of all physicians who do so.

Within the primary care workforce, 11.1 percent of family physicians practice in large rural areas, compared with 6.7 percent of general internists and 6.2 percent of general pediatricians, according to the data. More than 7 percent of family physicians, meanwhile, practice in small rural areas, compared with 2.4 percent of general internists and 1.8 percent of general pediatricians. In terms of isolated rural frontier areas, 4.2 percent of family physicians practice in these locations, compared with 1.1 percent of general internists and 0.8 percent of pediatricians.

The data break down the geographic distribution of physicians, nurse practitioners (NPs), and physician assistants (PAs) based on urban, large rural, small rural and isolated rural frontier areas. AHRQ asked the Graham Center to research this particular issue as part of a larger workforce study.

"These data confirm that family physicians continue to be the first contact for rural Americans needing medical care," said AAFP President Glen Stream, M.D., M.B.I., of Spokane, Wash., in a press release from the AAFP. "At the same time, it indicates that we need to do more to recruit students from rural areas into our medical schools. Research has consistently shown that medical school rural programs and medical school admissions policies that recruit rural students produce physicians who are likely to go into family medicine and practice in rural settings."

The U.S. primary care workforce includes approximately 209,000 practicing primary care physicians, 56,000 primary care NPs, and 30,000 primary care PAs, for a total of nearly 295,000 primary care professionals, according to the data.

According to the press release, the AAFP "has urged medical educators to adopt admissions policies that actively recruit students from rural areas." Several schools have responded by establishing comprehensive rural programs. Forty-five percent to 76 percent of graduates from these programs practice in rural areas, and 59 percent to 72 percent practice primary care, according to the AAFP.

Stream described rural family medicine residency training programs as "an important contributor to family physicians choosing and being prepared to practice in rural areas."

"Although family physicians and nurse practitioners are making a dent in meeting the demand for care among rural Americans, it's clear our education policy needs to encourage more people to go into family medicine and rural practice," Stream said. "As we work to address the problems of rural access to health care, we need to first look at the medical education system and its role in filling the primary care and rural care pipeline."