The decision for inside versus outside of major medical centers involved considerations of underservice. The percentage level of primary care physicians required to bring states up to 1 primary care physician per 2 000 were more strongly related to underserved physicians outside of MMC locations (0.7 correlation) as compared to underserved locations without consideration of MMC (0.5 correlation).
Both share relationships to underservice, but outside is strongest and most reflects the locations where physicians are most needed such as low income, whole county primary care shortage areas, and more isolated rural locations. Outside involves decisions made by states and the nation while inside involves decisions made mostly by those in major medical centers.
|
My codes |
Major Medical Center or MMC
|
Outside of Major Medical Centers |
Totals |
|||
|
Served |
Military |
Underserved Category |
||||
|
Poverty > 20% |
Designated - CHC, NHSC, Whole County |
|||||
|
Zip Codes |
3,335 |
19,225 |
115 |
3,845 |
5,457 |
31,977 |
|
Graduates since 1971 |
361,939 |
129,781 |
1,943 |
14,588 |
14,566 |
522,817 |
|
Population at zip 2000 |
89,994,404 |
129,935,621 |
905,395 |
24,604,434 |
28,363,078 |
273,802,932 |
|
Poverty Pop |
10,445,200 |
11,433,014 |
85,042 |
5,951,025 |
5,967,802 |
33,882,083 |
|
mean % for poverty |
11.6% |
8.80% |
9.4% |
24.2% |
21.0% |
12% |
|
Physicians per 1000 pop |
4.02 |
1.00 |
2.15 |
0.593 |
0.515 |
1.909 |
|
Physicians per 1000 in poverty |
34.65 |
11.35 |
22.85 |
2.45 |
2.44 |
15.430 |
Correlations at the state level also revealed a 0.7 correlation of state shortages of primary care physicians needed to meet shortage needs when using underserved categories excluding major medical centers compared to a 0.5 correlation when the underserved coding including major medical center locations. Clearly major medical centers serve underserved locations, but distributing physicians and other practitioners outside of major medical centers is clearly a major priority for any nation that hopes to deliver equitable health care to lower income, middle income, and rural populations. The practitioners stuck in major medical centers by a number of health policies are not going to distribute. See Primary Care Retention
Birth Origin and Ethnicity of Family Medicine Graduates