The Adequacy Of Physician Supply In Small Rural Counties

Prologue: Roughly one-quarter of Americans live in rural areas. Rural Americans share the same basic needs as do urban dwellers, one of the most fundamental of which is the need for health care. There is growing attention on the rural health scene, including the health status of rural residents, the status of rural hospitals, and the numbers of physicians that choose to practice in rural areas. In this article, David Kindig and Hormoz Movassaghi examine physician supply in small rural counties—those having fewer than 10,000 residents. Over the period 1975–1985, they find, the number of physicians per 100,000 residents grew almost three times faster for the entire United States than for rural areas, despite overall growth in supply. “To consider this issue,” they state, “we must have some standard or norm of availability that is desired or optimal for these locations. To our knowledge, no such standard exists.” Kindig, who received his medical degree and a doctorate in experimental pathology from the University of Chicago, is professor of preventive medicine and director of programs in health management at the University of Wisconsin, Madison, School of Medicine. His interest in physician supply began when he was president of the American Medical Student Association in the late 1960s, during a time when issues of distribution of physicians across the country first reached the national consciousness. As deputy director of the Bureau of Health Manpower, under the Department of Health, Education and Welfare, from 1974 to 1976, he helped to develop legislation that led to the formation of the Graduate Medical Education National Advisory Committee (GMENAC) and its landmark findings. Movassaghi is currently an assistant professor of finance at the School of Business, Ithaca College, Ithaca, New York. He holds a master of business administration degree and a master's degree in health administration from the University of Wisconsin, Madison, where he was a research assistant at the time this paper was completed.