Although the United States suffers from a well-known shortage of primary care physicians, an even greater challenge facing U.S. health care is the uneven geographic distribution of primary care physicians. These distribution problems underscore the need for policies to increase both the overall number of primary care physicians and to encourage a more equal distribution of physicians.
That's the conclusion of a one-page policy brief(www.graham-center.org) based on an analysis the Robert Graham Center for Policy Studies in Family Medicine and Primary Care(www.graham-center.org) conducted using data from the Agency for Healthcare Research and Quality.
The United States does not actively regulate the number, type or geographic distribution of its physician workforce. Health care professionals can choose how and where to work. As a result, workforce distribution and patients' access to care rely on market forces, often with important but inadequate intervention from the government, medical schools and safety-net programs. "The result is incongruency between the geographic location and specialty choice of the health workforce and enduring health care needs of the U.S. population," according to the brief.
The United States has about 80 primary care physicians per 100,000 people, which includes an average of 68 primary care physicians for every 100,000 residents in rural areas and 84 primary care physicians per 100,000 residents in urban areas. This unequal distribution "implies that many areas have relative primary care shortages, especially rural communities and areas of measurable social deprivation," says the brief.
To provide a primary care physician for every 2,000 Americans -- a commonly used threshold -- the United States needs an additional 2,670 rural physicians and an additional 3,970 urban physicians, according to the brief.
It notes that the need for more primary care physicians and a more even distribution of those physicians will become more acute as the health care reform law extends coverage to millions of currently uninsured people during the next few years.