More doctors practice in the most affluent areas while more nurse practitioners practiced in lower-income areas with low life expectancy.
The rural physician shortage is well-established, and there's the notion that doctors don't necessarily establish their practices where the need for healthcare is greatest -- in poor and unhealthy communities.
A new study from researchers at the University of Michigan found that more physicians, physician assistants and chiropractors are available in the most affluent areas with already-high life expectancy, which falls in line with conventional thinking. But more nurse practitioners practiced in lower-income areas with low life expectancy, which could to some degree offset a dearth of doctors in high-need areas. The researchers used life expectancy as an indicator of the need for healthcare.
There were 30 percent more physicians, but 15 percent fewer nurse practitioners, in the highest-income areas when compared to the lowest-income areas, the findings showed. When the researchers examined where nurse practitioners work, they found that the availability of nurse practitioners was about 50 percent higher in the least healthy counties compared with the healthiest.
The availability of physician assistants mirrored that of physicians, probably because these two disciplines are often tied together through licensure.
Chiropractors were most likely to work in areas of high income and greater health, likely because most are small business owners, and would likely want to locate in higher-income areas, where demand is greater.
A study last year conducted for the Association of American Medical Colleges predicted a shortage of between 40,800 and 104,900 primary and specialty care physicians by 2030. One thought is that the growing number of physician assistants and nurse practitioners can help meet the growing demand for primary care. The Bureau of Labor Statistics projects that the number of physician assistants and nurse practitioners will grow 37 percent and 31 percent, respectively, which is much faster than the 7 percent average growth for other occupations.
This is due to the aging population, demand for preventive care and an overall increased demand for healthcare services. Employment of physicians and surgeons is expected to grow just 13 percent during the same time period.