The distribution of America's medical schools and the persistent problem of physician access

This thesis is a study of the relationship between the number of medical schools in a state and physician access, and the implications of this for rural and poor Americans. Access to care is a growing concern in the United States today. Research confirms that health status indicators including rates of life expectancy, timely treatment, and preventative care all increase with physician access. Access disparities have led the federal government to provide funding and incentives for physicians practicing in regions known as designated Health Professional Shortage Areas (HPSAs). One possible explanation for the persistence of this problem is that medical schools have been historically located in urban centers on the East Coast in geographically smaller states. By examining the relationship of the number of medical schools in each state to the ratio of physicians to population in each state, I hope to shed light on the phenomenon of the rural physician shortage, including the sources of this problem and how it might be addressed. Research on this topic is particularly relevant today because the “Silver Tsunami” brought about by the aging of the American population promises to significantly increase demands for health care in the United States. Increasing demands will be difficult to meet through the existing rate of expansion of the physician workforce. In this context, physician access and state medical schools are worth examining.