Half of U.S. Counties Have No Ob-Gyn

For decades those proceeding in higher education and in health professional training have been increasing in income level and increasing in most urban origins. This is the result of birth to education changes in the US national designs. About 32% of residents in training were born in other nations and collectively have the lowest levels of distribution at 80% found where workforce is most saturated compared to 72% for the national average.

Health care spending insures multiple times more health spending per capita for 1000 zip codes in 1% of the land area - insuring ever greater concentration for those who by their upbringing and their training desire to live in greater concentrations.

Ob-gyn docs have no major difference in distribution compared to the US average. Only family practice MD and DO (95% of FM grads) as well as the employed family practice NP (25% of total NP) and PA grads (18% of entering PA workforce) have the multiple times greater distribution to all counties, zip codes, and states with lower to lowest workforce.

When US MD and DO training prevent family medicine entry and when flexibility allows NP and PA grads to avoid or depart family practice, the result is more elderly, rural, underserved, lower income, and middle income Americans falling to lower or no access.

General surgical workforce (including basic ob-gyn trained) is greatly needed in rural areas, but origins, selections, and training influences are exactly the opposite of need. Few pause at general surgical careers as fellowships dominate, and this does not facilitate the general surgical types needed for rural areas.

Primary care is 40 - 100% of the workforce in 30,000 zip codes left behind and family practice is 40 - 100% of primary care workforce in these locations. When workforce drops below 50 per 100,000, it is typically family practice that is the only workforce remaining.

Obligated general surgical workforce, rural medical schools, and entire clinical years of medical school (MN Rural Physicians Associates Program) are the only solutions that have demonstrated success in resolving deficits of general surgical workforce.

Until you hear this from the designers, you can rest assured that significantly better distribution is not the intent.

Robert C. Bowman, M.D. of AZ 12:44AM May 26, 2012