Understanding How the Diffusion of Physicians Creates Areas of Underservice

Investigators: Thomas Ricketts, PhD; Erin Fraher, PhD, MPP; Andy Knapton, MSc

Background: States and the federal government devote substantial resources to influence physicians to practice in underserved areas.  Like the general population, the physician workforce is mobile.  About 20% of the active employed physician workforce will relocate to another county within a five-year period. Federal and state policies affect these choices using a combination of economic (extrinsic, e.g. bonus payments, subvention of loans) and personal (intrinsic, e.g. promoting volunteerism) factors.

Objective/Aims: The central hypothesis of this project is that future physician moves can be estimated based on historical patterns, on where there is need for specific types of health care services and where there are hospitals or other health services infrastructure that act as a “magnet” to the workforce.

Methods: The project will use multiple years of American Medical Association Physician Masterfile data, American Hospital Association data, and the Area Health Resource File to identify localities that are at risk of becoming underserved or of having their degree of underservice intensify over the next 10-15 years.

Policy Relevance:  This project will provide data on where resources would be best invested now and in the future to incent physicians to practice in underserved areas.  The parameters derived from the analysis will be used to refine predictive models of physician supply and demand as well as models for other professions