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 area, 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.