More and better rural physicians that stay longer.... Rural family physicians concentrate away from major medical centers in all other locations in the nation. With decreasing income, education, facilities, physicians, and population density the concentrations of family physicians increase and the breadth of scope continues to increase. Family physicians are 57% outside of Major Medical Centers (see table). Generalist Internal Medicine and generalist pediatrics are 69% inside of major medical centers. Family physicians over time migrate away from major medical centers. Those most likely to choose family medicine are more Service Oriented as best exemplified by Rural Interested Senior Medical Students who had 68% choice of family medicine and 60% were interested in serving a socioeconomically deprived area, the highest level of any group identified. Family physicians are 50% of the total physicians from all sources in Community Health Centers (CHCs) and 61% in rural CHCs are family physicians. (Rosenblatt)
Primary Care Retention - Family physicians are retained in primary care and in rural practice, not so with other practitioners.
What is wrong with primary care and family medicine is what is wrong with the nation, with poor distributions of education, health resources, and economics that affect all of the service orientated professionals, especially school teachers, nurses, public servants, and family physicians. When the nation has health care outside of major medical centers as a priority, family medicine choice thrives. Five Periods of Health Policy and Physician Career Choice When the nation fails to support infrastructure, those most likely to choose family medicine have a difficult time with the pipeline.Those most likely to choose family medicine and to distribute where needed are losing out in admission. Admissions Ratios, Changing Admissions, and Physician Distribution There are those that would attempt to fix this poor status quo in place. (Propositions) Choice of family medicine doubles the distribution of all types of medical students to rural and to underserved areas. For more on Family Medicine Physician Distribution including graphics and tables.
Be Proud to be a Family Physician Family Physicians Are Different In almost every characteristic that matters to admissions, those choosing FP are different. It takes different to be different in career choice, location, and integration.
The Role of the Rural Community and Practitioner
FAMILY PHYSICIAN OF THE YEAR RECIPIENTS 1977 - 2004
Procedures, colonoscopy, endoscopy, deliveries, cesarean sections, emergency care, mental health, women's health, and child care.
World of Rural Medical Education site at Rural Medical Education
Top 50 Family Medicine Residency Programs in Rural Rankings
Before Admissions - Physician workforce for the US can be predicted by characteristics of US medical schools. If the US truly desires more to serve underserved areas, it better start with education and work through admissions first and foremost.
Admissions and Social Status Could it be that rural, older, instate are all proxies for social status
Choice of Family Medicine: Past, Present, Future
Nebraska's Rural Family Practice Programs
Choice of FP Update Progress beyond the Arizona Study
Rural Choices by Medical School Type, Allopathic or Osteopathic, Public or Private
Rural and Urban Comparison of all FP graduates as of 2003 - states vary in the types of rural practices, see where the new graduates are going
Family Medicine Physician Distribution
FP Graduates 1997 - 2003 Summary Tables
www.jabfm.org/cgi/content/full/16/2/182 A Fast Track for Rural Family Physicians see also Accelerated Family Medicine Training Programs
Heroes in Medicine - lots of rural family docs