National Physician Supply Grew at Twice the Rate of the U.S. Population

The number of physicians in the United States increased about 26 percent,  from about 541,000 to about 681,000 from 1991 to 2001. Physician growth  was twice that of national population growth during this period. The national  physician workforce maintained approximately a one-third generalist to  two-thirds specialist composition between 1991 and 2001. In 1991, 8 metropolitan areas and 27 statewide  nonmetropolitan areas had fewer than 100 physicians per 100,000 people. See appendix  III for information on physician supply by state metropolitan and  nonmetropolitan areas in 1991 and 2001. Physician Supply Per 100,000 People Increased in Most Areas but Geographic Disparities Persisted

All 48 statewide nonmetropolitan areas experienced an increase in the  number of physicians per 100,000 people from 1991 to 2001 and 301 of 318  metropolitan areas experienced an increase in physicians per 100,000  people. Overall, the nonmetropolitan areas had higher proportional growth  in physicians per 100,000 people than the metropolitan areas, but the  disparity in the supply of physicians per 100,000 people between the  metropolitan and nonmetropolitan areas persisted. Rates of growth in the  number of physicians per 100,000 people, the supply of physicians per  100,000 people, and the mix of generalists and specialists among  categories of metropolitan and nonmetropolitan counties varied. The disparity in the supply of physicians  per 100,000 people between nonmetropolitan and metropolitan areas  persisted because physicians continued to disproportionately locate in  metropolitan areas. While nonmetropolitan counties with a large town (10,000 to  49,999 residents) had the biggest percentage increase in physicians per  100,000 people of all county categories, their supplies per 100,000 people  were still less than large and small metropolitan counties’ supplies in 1991  and 2001. Agency Comments

We provided a draft of this report to HRSA for comment.
Why GAO Did This Study

Through a variety of programs, the federal government supports the training of physicians and encourages physicians to work in underserved areas or pursue primary care specialties. GAO was asked to provide information on the physician supply and the generalist and specialist mix of that supply in the United States and the changes in and geographic distribution of physician supply in metropolitan and nonmetropolitan areas. To address these objectives, GAO analyzed data on physician supply and geographic distribution from 1991 and 2001.

What GAO Found

The U.S. physician population increased 26 percent, which was twice the rate of total population growth, between 1991 and 2001. During this period the average number of physicians per 100,000 people increased from 214 to 239 and the mix of generalists and specialists in the national physician workforce remained about one-third generalists and two-thirds specialists. Growth in physician supply per 100,000 people between 1991 and 2001 was seen in historically high-supply metropolitan areas as well as low-supply statewide nonmetropolitan areas. Between 1991 and 2001, all statewide nonmetropolitan areas and 301 out of the 318 metropolitan areas gained physicians per 100,000 people. Of those 17 metropolitan areas that experienced declines in the number of physicians per 100,000 people, only 2 had fewer total physicians in 2001 than 1991. Overall, nonmetropolitan areas experienced higher proportional growth in physicians per 100,000 people than metropolitan areas, but the disparity in the supply of physicians per 100,000 people between nonmetropolitan and metropolitan areas persisted. Nonmetropolitan counties with a large town (10,000 to 49,999 residents) had the biggest increase in physicians per 100,000 people of all county categories but their supplies per 100,000 people were still less than large and small metropolitan counties' supplies in 1991 and 2001. In written comments on a draft of this report, the Health Resources and Services Administration agreed with GAO findings of persisting disparities between metropolitan and nonmetropolitan areas.