Changes in the supply of primary care physicians in rural areas in the USA, 1990-2000

The shortage of primary care physicians (PCPs) is a persistent problem in the rural USA. The purpose of the study is to document the differential growth in the supply of selected types of PCPs between rural and urban areas in the USA for the years, 1990, 1995 and 2000. Based on the data from 2002 Area Resource File, a supply gap index was created to measure the degree of imbalance in PCP supply between rural and urban areas. The gap in the supply of general internal medicine (GIM), general paediatrics (GP), general Ob/Gyn (GOG), emergency (EM) physicians between urban and rural areas increasingly narrowed over the last decade. However, the supply of general/family practice (GFP) physicians known as 'rural doctors' continued to decrease in rural areas over the last decade. As a result, the imbalance in the supply of all PCPs combined between urban and rural areas widened over the last decade. The higher the degree of rurality of rural areas, the higher the increase in the gap. More efforts to increase the GFP supply in the nation and monitor the GFP supply in rural areas are needed.