The Country Doctor: Study Anticipates a Disappearing Breed that Doesn’t Bode Well for Rural America
Rural counties throughout the United States may be hardest hit by the country’s anticipated shortage of primary care physicians (PCPs), according to a new study from the WWAMI (Washington, Wyoming, Alaska, Montana, and Idaho) Rural Health Research Center at the University of Washington School of Medicine.
Researchers point to several factors that have implications for rural counties: PCPs deliver the majority of health care in those areas; a substantial percentage of primary care providers in the United States are approaching retirement age at the same time that fewer new medical school graduates are opting for primary care specialties; and demand for health care services is expected to increase as the population ages and millions gain health insurance coverage as a result of the Affordable Care Act.
The study, which used data from the American Medical Association and the American Osteopathic Association 2005 Physician Masterfiles, found a higher percentage of PCPs near retirement in rural counties than in urban ones, with the percentage increasing as the degree of rurality increased. (Physicians 56 or older in 2005 were considered to be near retirement and were the primary focus of analysis.) The 184 counties in the top 10 percent of near-retirement PCPs were characterized by lower population density and lower socioeconomic status, as measured by low education, low employment, and persistent poverty.
There were 166 rural counties without any PCPs at all. Also, at least 30 percent of rural PCPs were 56 or older in 11 states: Arkansas, California, Connecticut, Florida, Massachusetts, Nevada, North Dakota, Oklahoma, Oregon, Vermont, and West Virginia.
The study concludes that identifying states and counties at a particularly high risk for PCP attrition through retirement can help inform policy and planning decisions that may help avoid PCP shortages in vulnerable locations.