Diffusion of Physicians and Access to Primary Care: The Role of Person, Program, and Place

Thomas C. Ricketts, PhD, MPH

Key Findings:

1) It is not currently possible to generate models that predict who will move into or out of a rural HPSA or which rural HPSAs are more or less likely to attract physicians.
2) Federal programs and incentives that seek to promote practice in underserved communities are only one of a number of factors that influence a physician’s choice of practice location.
3) We have seen an overall steady and relatively well-distributed pattern of growth in physician supply. At the same time we have seen an overall increase in the number of areas designated as HPSAs despite growth in provider supply.
4) Analyses need to be conducted over a longer time period at a more fine-grained level to better understand the role of physicians serving in underserved places.
5) The cumulative effect of federal policies in reducing or eliminating geographic shortages is not known. A comprehensive evaluation is needed to judge the effects of current policies and factors that influence choice of location or the potential for emerging underservice.


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