Robert C. Bowman, M.D.
Choice of family medicine consistently doubles distribution to the most needed rural and underserved locations.
Distribution Differences By Medical School Type By Career Choice: Family Practice/General Practice (FPGP) or Not FPGP
|
1987 – 1998 US Graduates |
|
Urban Served |
Urban Under served |
Rural Served |
Rural Under served |
Urban Major Medical Center |
Rural Major Medical Center |
Military |
All Rural |
All Under served |
|
Puerto Rican Medical Schools |
Not FPGP |
33.30% |
7.60% |
4.90% |
1.70% |
50.60% |
0.80% |
1.10% |
7.30% |
9.30% |
|
FPGP |
38.40% |
9.70% |
7.60% |
5.90% |
35.70% |
1.10% |
1.60% |
14.60% |
15.70% |
|
|
Increase By % |
15.3% |
27.6% |
55.1% |
247.1% |
-29.4% |
37.5% |
45.5% |
100.0% |
68.8% |
|
|
Historically Black Medical Schools |
Not FPGP |
17.10% |
6.20% |
2.70% |
2.40% |
67.60% |
1.60% |
2.40% |
6.60% |
8.60% |
|
FPGP |
25.00% |
12.00% |
6.40% |
5.70% |
45.00% |
2.40% |
3.50% |
14.40% |
17.70% |
|
|
Increase By % |
46.2% |
93.5% |
137.0% |
137.5% |
-33.4% |
50.0% |
45.8% |
118.2% |
105.8% |
|
|
Early Admission UMKC, NEOUCOM |
Not FPGP |
14.50% |
1.90% |
4.00% |
1.00% |
74.80% |
2.50% |
1.20% |
7.60% |
2.90% |
|
FPGP |
31.50% |
3.40% |
9.90% |
7.20% |
42.80% |
3.10% |
2.10% |
20.20% |
10.60% |
|
|
Increase By % |
117.2% |
78.9% |
147.5% |
620.0% |
-42.8% |
24.0% |
75.0% |
165.8% |
265.5% |
|
|
UCLA, UC Irvine, UC Davis, U Washington |
Not FPGP |
9.80% |
3.30% |
2.70% |
1.50% |
80.10% |
2.00% |
0.70% |
6.10% |
4.80% |
|
FPGP |
19.10% |
6.90% |
6.30% |
5.70% |
58.30% |
2.80% |
0.90% |
14.80% |
12.60% |
|
|
Increase By % |
94.9% |
109.1% |
133.3% |
280.0% |
-27.2% |
40.0% |
28.6% |
142.6% |
162.5% |
|
|
MCAT 10.5-12 |
Not FPGP |
9.50% |
1.80% |
2.00% |
0.80% |
82.90% |
1.70% |
1.30% |
4.50% |
2.60% |
|
FPGP |
20.80% |
5.60% |
8.90% |
4.60% |
55.00% |
2.80% |
2.30% |
16.30% |
10.20% |
|
|
Increase By % |
118.9% |
211.1% |
345.0% |
475.0% |
-33.7% |
64.7% |
76.9% |
262.2% |
292.3% |
|
|
MCAT 10-10.5 |
Not FPGP |
12.10% |
1.90% |
3.20% |
1.00% |
77.20% |
2.70% |
1.90% |
7.00% |
3.00% |
|
FPGP |
25.20% |
3.60% |
14.90% |
4.00% |
46.90% |
3.00% |
2.30% |
22.00% |
7.70% |
|
|
Increase By % |
108.3% |
89.5% |
365.6% |
300.0% |
-39.2% |
11.1% |
21.1% |
214.3% |
156.7% |
|
|
MCAT 9.5-10 |
Not FPGP |
13.30% |
2.30% |
3.50% |
1.60% |
75.10% |
2.40% |
1.80% |
7.50% |
3.90% |
|
FPGP |
24.70% |
4.50% |
12.80% |
5.80% |
47.10% |
2.70% |
2.40% |
21.30% |
10.30% |
|
|
Increase By % |
85.7% |
95.7% |
265.7% |
262.5% |
-37.3% |
12.5% |
33.3% |
184.0% |
164.1% |
|
|
MCAT 9.25-9.5 |
Not FPGP |
12.20% |
2.90% |
4.10% |
2.60% |
71.90% |
4.30% |
2.00% |
11.00% |
5.50% |
|
FPGP |
21.40% |
6.00% |
12.20% |
8.40% |
45.00% |
4.60% |
2.30% |
25.20% |
14.40% |
|
|
Increase By % |
75.4% |
106.9% |
197.6% |
223.1% |
-37.4% |
7.0% |
15.0% |
129.1% |
161.8% |
|
|
MCAT 8.5-9.25 |
Not FPGP |
11.10% |
3.70% |
5.50% |
3.70% |
70.20% |
4.30% |
1.60% |
13.50% |
7.30% |
|
FPGP |
22.20% |
5.40% |
16.60% |
11.10% |
38.30% |
4.80% |
1.70% |
32.50% |
16.50% |
|
|
Increase By % |
100.0% |
45.9% |
201.8% |
200.0% |
-45.4% |
11.6% |
6.3% |
140.7% |
126.0% |
|
|
Osteopathic Lower MCAT |
Not FPGP |
19.40% |
3.00% |
6.80% |
4.00% |
60.30% |
4.30% |
2.20% |
15.20% |
7.00% |
|
FPGP |
26.40% |
4.50% |
10.90% |
8.10% |
43.70% |
3.80% |
2.60% |
22.80% |
12.50% |
|
|
Increase By % |
36.1% |
50.0% |
60.3% |
102.5% |
-27.5% |
-11.6% |
18.2% |
50.0% |
78.6% |
|
|
Osteopathic Higher MCAT |
Not FPGP |
19.20% |
3.00% |
7.30% |
2.70% |
61.50% |
4.30% |
2.00% |
14.30% |
5.70% |
|
FPGP |
29.60% |
3.90% |
12.40% |
6.80% |
41.90% |
3.60% |
1.90% |
22.70% |
10.70% |
|
|
Increase By % |
54.2% |
30.0% |
69.9% |
151.9% |
-31.9% |
-16.3% |
-5.0% |
58.7% |
87.7% |
|
|
Uniformed Services |
Not FPGP |
10.20% |
2.10% |
3.00% |
1.10% |
39.20% |
1.40% |
43.00% |
5.50% |
3.20% |
|
FPGP |
12.10% |
2.40% |
3.80% |
5.40% |
27.20% |
1.10% |
48.00% |
10.20% |
7.80% |
|
|
Increase By % |
18.6% |
14.3% |
26.7% |
390.9% |
-30.6% |
-21.4% |
11.6% |
85.5% |
143.8% |
|
|
All US Graduates
|
Not FPGP |
12.70% |
2.50% |
3.60% |
1.70% |
74.50% |
2.80% |
2.10% |
8.20% |
4.30% |
|
FPGP |
24.50% |
4.90% |
12.40% |
6.70% |
45.40% |
3.40% |
2.70% |
22.60% |
11.60% |
|
|
Increase By % |
92.9% |
96.0% |
244.4% |
294.1% |
-39.1% |
21.4% |
28.6% |
175.6% |
169.8% |
Family medicine choice consistently results in facilitation of distribution to all locations other than major medical centers. Distributions to rural and rural underserved areas are much greater with moderate increases for urban underserved areas.
All other specialty choices lead to 69% - 92% location in major medical centers. Office internal medicine and office pediatrics are not able to facilitate distribution. Rural or lower income practice contributions are related to rural or lower income origins.
The secret of physician distribution is really no secret. Physician distribution is about facilitating distribution away from major medical center locations. Admissions of those “outside,” training focused on locations outside, focus on careers that locate outside, and health policy that facilitates outside locations all improve physician distribution. Current medical education admits more and more with major medical center connections for the first 30 years of life, trains almost entirely in major medical centers with a focus on major medical center practice, and promotes health policies that support continued concentrations of health resources within major medical center locations.
Major Medical Centers for definitions of locations