Assessing Shifts in Outpatient Visits to Physicians of Other Specialties in Rural Areas with Shortages of Cardiologists and Gastroenterologists: A Preliminary Analysis

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Donald E. Pathman, MD MPH; G. Mark Holmes, PhD; Samuel Berchuck, BS; James W. Terry, Jr., BA

Conclusions and Implications for Policy

  1. In response to local physician shortages in a given medical specialty, physicians of other specialties will sometimes adapt the services they provide to meet local service needs (“service shifting”).
  2. Healthcare workforce planners should be mindful that service shifting across specialties can mitigate the effects of local shortages of specialists by offsetting local health care service shortfalls, i.e., local shortages in some specialties do not always yield local service shortages.
  3. Medical educators and policy makers should ensure that residencies in many and perhaps most specialties prepare graduates so that they have the breadth of skills to step up to provide the range of services that their communities may need.
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