Future of Family Medicine and Implications for Rural Primary Care Physician Supply

摘要

The precipitous decline in student interest in the field of family medicine over the past decade is exacerbating the crisis posed by the persistent shortage of providers in rural areas of the United States. Family physicians are the foundation of the rural health care system, with generalists accounting for almost half of rural physicians. Their presence is even more critical in the smallest and most isolated communities where they constitute the majority of all physicians. This policy discussion examines the rural physician shortage, the effect of recent trends in specialty choice on provider supply, and major trends that are changing the dynamics that shape the delivery of health care. It concludes with a discussion of how private efforts and federal and state policy options can be refined to ensure adequate and high-quality health care in rural America. This report is based on estimates of the future supply of family physicians, taking into account recent patterns in specialty choice. We performed analyses of medical school graduates from 1988 through 1997, determining the discipline they entered, the location of their residency programs, and where they decided to practice, on an urbanrural continuum. We selected these cohorts to allow us to follow the career trajectories of the most recent graduates (from 1997) through residency training (3-5 years) and establishment of their practices.