Changes in the distribution of physicians in rural areas of Minnesota, 1965-85

A descriptive analysis of health insurance coverage among farm families in Minnesota

This paper reports the findings of a study of health insurance coverage and access to health services among farm families in Minnesota. The study included 1,482 families actively engaged in farming during 1989. While less than 10 percent of the population were uninsured during this period, the majority had limited coverage with high deductible and coinsurance provisions. Moreover, they were paying an estimated 15 to 20 percent more for their plans than a similar plan would have cost in the Minneapolis-St. Paul, MN, area. With the exception of cost, satisfaction with health services was found to be very high, and there were few indications of access problems.

Pharmaceutical care for rural patients: ominous trends

The findings of the Lake Superior Rural Cancer Care Project may be a harbinger of impeding shortages of pharmacists in most rural areas of the United States. Elderly patients, the population that is most reliant on medication, constitute a large portion of the citizens who are potentially underserved in terms of pharmaceutical care in rural areas. Education for rural practice is largely overlooked in current pharmacy curricula. The national pharmacy leadership must develop a sensible workforce policy that considers the needs of rural patients.

The increasing supply of physicians in US urban and rural areas, 1975 to 1988

BACKGROUND

Despite the rapid growth of the US physician supply since the mid-1970s, it remains unclear whether physicians have spread into the most rural areas of the country. This report examines the urban-rural distribution of physicians between 1975 and 1988.

METHODS

A county-based typology of the urban-rural continuum was employed to examine trends in the supply of nonfederal primary care physicians, specialist physicians, and osteopaths.

RESULTS

All urban and rural areas gained physicians during the late 1970s and 1980s. The supply of physicians increased most rapidly in metropolitan counties. Within nonmetropolitan areas, urbanized remote counties became more prominent centers of the physician supply. Osteopaths were more likely to locate in the most rural areas than allopaths. The physician supply in all areas also became more specialized over time.

CONCLUSIONS

The rapid growth of the US physician supply was associated with the spread of more practitioners into all parts of the country. However, the supply of physicians increased most rapidly in urban areas, widening urban-rural differences in the availability of physicians.

Career trends of master's prepared family nurse practitioners

The purpose of this study was to examine the career trends of family nurse practitioner (FNP) graduates of one master's program. A questionnaire was mailed to all FNPs (N = 113) who graduated 1-11 years earlier; there was a response rate of 83%. The survey revealed that for both first and present jobs the majority were providing direct patient care as a primary care provider or practicing in an indirect role. The study findings indicate that for these graduates there is a long term commitment (demonstrated through continued employment) as well as opportunity to practice in the nurse practitioner role in a direct or indirect capacity.

The effects of area health education centers on primary care physician-to-population ratios from 1975 to 1985

The purpose of this study was to explore how the primary care (PC) physician-to-population ratio changed from 1975 to 1985 in counties that were served by an Area Health Education Center (AHEC) in contrast to those counties that were not. The investigation attempted to determine whether any observed changes in this ratio were dependent upon either degree of urbanization or contiguity to a Standard Metropolitan Statistical Area (SMSA). The data source for this study was the Area Resource File. Results indicated that: (a) irrespective of AHEC status, increased degree of urbanization across counties was associated with relatively more PC physicians in both 1975 and 1985; (b) PC physician-to-population ratios increased from 1975 to 1985 for all American Medical Association (AMA) county code categories, regardless of AHEC versus non-AHEC designation; (c) AHEC counties demonstrated greater (or equivalent) absolute improvement for all AMA county code categories except for several categories which represented more urbanized counties; (d) for the least urbanized counties in the AMA code, the percentage improvement in PC physician-to-population ratios for AHEC counties ranged from 3 to 5 percent higher than corresponding percentage improvement in ratios for non-AHEC counties; and (e) AHEC counties showed greater absolute and percentage improvement in PC physician-to-population ratios than did non-AHEC counties for counties not contiguous to SMSAs.

Medical practice and satisfaction of physicians in sparsely populated rural countries of the United States: results of a 1988 survey

The results are reported from a mail survey to a 25 percent sample of all allopathic and osteopathic physicians practicing in countries less than 10,000 population in 1988. Overall, 71 percent of respondents indicated that they were satisfied with their practice in those areas but 23 percent indicated dissatisfaction and 26 percent planned to leave those areas within five years. Factors associated with practice dissatisfaction included lower income, long hours worked, increase in patients with inadequate medical insurance and distance from a major referral center. Thirty-two percent of respondents indicated that there were too few physicians in their counties and in aggregate projected a need for 1,100 additional physicians, or approximately a 50 percent increase relative to the current supply of physicians in such counties. Seventy-four percent of those indicating a need for more physicians stated that in their opinion the community in which they were practicing could support such additions. The survey results indicate an underlying satisfaction with rural practice but suggest the need for ongoing educational and financial incentives for such practices if the delivery of health care services in rural areas is to be improved.