Dr-Sara Machado.jpeg

Disparities in Physician Density by Specialty Type in Urban and Rural Counties

MedicalResearch.com Interview with:

Dr-Sara Machado.jpeg

Dr. Machado

Sara Machado PhD
Fellow at the Department of Health Policy
London School of Economics and Political Science

MedicalResearch.com: What is the background for this study?

Response: Physician distribution is a determinant of health care access, so knowing how physician density patterns evolve over time is important if we are trying to address disparities in access to care. Moreover, the last 10 years have brought about changes in health care coverage, across the US. Recent evidence points to an uneven physician distribution between urban and rural communities. We examined recent trends in physician density by physician category across rural and urban US counties. 

MedicalResearch.com: What are the main findings?

Response: We have two main findings.

  • First, density of primary care physicians steadily decreased in more than half of rural counties (994 out of 1,976).
  • Second, medical specialist density, which would care for cardiovascular and pulmonary disease, for example, has been largely stagnant in rural counties, at the lowest density levels (less than 10 physicians per 100,000), and increasing in metropolitan counties.

MedicalResearch.com: What should readers take away from your report?

Response: I see two main points.

  • First, this study’s data support improved incentive structures to redistribute physician resources to match the unequal health burden experienced by rural and urban populations in the US.
  • Second, the Covid-19 pandemic has spurred expanded virtual options to deliver care, which means we need dedicated strategies to extend the reach of clinicians and prospective monitoring of equity of access are needed to promote rural health. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: It is important to understand the drivers behind physician density, as those can play a crucial role in promoting equity in access to health care, especially in face of the current technological evolution of care delivery.

No disclosures from me.


Machado SR, Jayawardana S, Mossialos E, Vaduganathan M. Physician Density by Specialty Type in Urban and Rural Counties in the US, 2010 to 2017. JAMA Netw Open. 2021;4(1):e2033994. doi:10.1001/jamanetworkopen.2020.33994 



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Last Updated on January 22, 2021 by Marie Benz MD FAAD