Rural-urban differences within primary care scope of practice

Investigators: Ryan Kandrack, PhD, Erin Fraher, PhD, Mark Holmes, PhD

There is some evidence that primary care physicians in rural areas respond to the limited local supply of specialists by offering a broader array of clinical services than their urban colleagues. These studies suggest that there is “plasticity” in the scope of services provided by physicians. Plasticity describes the dynamic and real world nature of scope of practice; physicians within the same specialty may provide different types of services depending on their demographic characteristics and training, the density of other physicians who provide overlapping services in their local area, the needs of their local patient population, and their personal preferences. Previous studies have described primary care physicians’ plasticity between rural and urban locations but little work has been done investigating the factors that affect plasticity within primary care specialties. The goal of this project is to investigate how the breadth and volume of primary care services varies within family medicine and general internal medicine between rural and urban areas.