Distributional Medical Schools: The Lost Lesson of Specific Forms of Government Support

Robert C. Bowman, M.D.     No funding was obtained from any source regarding this study.

 

The six osteopathic public schools created from 1972 to 1978 consistently lead the nation in percentages of family physicians, primary care physicians, rural physicians, retention in the same state as their medical school, and underserved locations. Osteopathic public schools gave opportunities to a broad range of instate students who have returned the favor by staying within the state at the highest levels and distributing sustained health care, economics, and leadership to the highest need areas of the state. The impact of government funding is also seen in the state funded Duluth program, the newer allopathic medical schools (federal Quillen programs involving Veterans Hospitals and primary care emphasis), the comprehensive statewide efforts at Iowa and Arkansas, and the multi-state plus statewide efforts at the University of Washington and the U of North Dakota.

 

The successes of these schools should have lower and middle income and rural peoples asking why there are so few? Others should ask why any other type of school is allowed to expand. Any school can graduate subspecialists, but only a few can distribute physicians where they are most needed. Schools that cost less and do more appear to be a best buy.

 

1987 - 1999 Graduates

State

Total

FPGP

Retained Instate

Rural

Rank

Under-served

Rank

Allopathic Private

 

75286

9.0%

29.0%

7.4%

 8

5.0%

 8

Allopathic Public

 

128341

16.0%

47.1%

13.0%

 3

7.3%

 6

Osteopathic Private

 

16201

33.8%

33.4%

17.6%

 2

8.5%

 3

Osteopathic Public

 

6335

35.1%

55.5%

22.7%

 1

12.7%

 1

North American

 

9786

17.1%

 

7.7%

 7

8.8%

 2

Distant International

 

53209

7.8%

 

9.0%

 6

7.9%

 4

Caribbean 3 with US

 

5098

19.0%

 

11.4%

 4

7.9%

 5

Graduates in 2005 locations

 

294256

14.2%

 

11.1%

 5

7.1%

 7

1987 - 1999 Graduates

State

Total

FPGP

Retained Instate

Rural

Rank

Under-served

Rank

U MN Duluth

MN

283

52.5%

60%

33.3%

3

5.0%

92

Kirksville Osteopathic

MO

1669

43.0%

13%

29.6%

5

11.6%

24

West Virginia Osteopathic

WV

761

42.1%

31%

39.1%

1

24.3%

1

U North Texas Osteopathic

TX

1209

41.6%

63%

19.8%

23

15.3%

10

Western Osteopathic

CA

1578

41.1%

46%

14.4%

48

10.8%

27

Oklahoma St U Osteopathic

OK

920

36.3%

51%

27.3%

7

18.2%

5

Kansas City Osteopathic MO

MO

1802

35.8%

15%

23.5%

14

11.9%

20

Ohio U Osteopathic

OH

1177

35.4%

60%

22.2%

15

7.5%

47

Des Moines Osteopathic

IA

2302

35.2%

14%

21.9%

17

8.8%

35

U New England Osteopathic

ME

959

33.8%

18%

19.1%

28

6.0%

73

Michigan St Osteopathic

MI

1528

32.0%

64%

18.9%

30

6.8%

58

Nova SE Osteopathic

FL

1380

31.3%

50%

12.1%

63

11.7%

21

Philadelphia Osteopathic

PA

2715

30.9%

47%

14.9%

46

5.6%

80

UMDNJ Osteopathic

NJ

736

28.3%

50%

11.1%

72

7.2%

50

Midwest Osteopathic

IL

1555

31.1%

36%

14.2%

49

5.9%

77

Mercer

GA

483

30.2%

67%

35.9%

2

22.0%

3

U South Dakota

SD

619

29.9%

39%

33.0%

4

5.4%

87

U North Dakota

ND

683

28.3%

31%

25.8%

9

6.9%

56

Wright State

OH

1123

28.2%

49%

17.3%

35

7.0%

55

Oral Roberts (closed)

OK

165

27.0%

8%

19.6%

24

13.0%

12

New York Osteopathic

NY

2017

26.0%

54%

9.1%

88

g4.9%

93

Iowa

IA

2117

25.9%

32%

18.2%

32

5.6%

82

Arkansas

AR

1656

25.5%

58%

26.8%

8

11.5%

25

U Washington

WA

2055

25.3%

47%

17.5%

34

8.1%

44

Brody East Carolina

NC

875

24.8%

56%

24.0%

13

12.1%

17

Others available by request

 

FPGP physicians were used because the AMA Masterfile classifies many osteopathic trained family physicians as general practitioners. Rural areas were not urban codes in the RUCA 1.1 listing and were not the ".1" codes indicating 30% or more commuting to urban areas for work. Underserved areas were zip codes with 20% of more in poverty or zip codes shared with a whole county shortage area, a Community Health Center, or a National Health Service Corps site. For definitions and physician distribution table in the US see Major Medical Centers

 

Physician Workforce Studies

 

www.ruralmedicaleducation.org