Inter-state Migration Pattern of Physicians, 2000 to 2010

Purpose: This study examines the inter-state migration patterns of the clinically active physicians between 2000 and 2010. Geographic maldistribution of the health workforce in the US contributes to the disparities in the public's access to health care.

Data Sources and Study Design: Physician movements are observed by physician addresses in the American Medical Association (AMA) Masterfiles. Physician addresses are geocoded and linked to rural urban continuum, areas of under-service, and census data via the Geographic Information Systems. The movement of physicians is then examined in a logistic regression model. Namely, migration is predicted by physician specialties and demographic characteristics and by differences in income, poverty, educational attainment, and racial composition of the origin and destination across states. Spatial relationship in terms of distance, contiguity, and regions are also entered into the spatial interaction model.

Results: Preliminary results suggest that 23% of clinically active physicians moved across states from 2000 to 2010. Physician movement shows a clear geographic pattern. Physicians tend to move from the northeastern, Midwestern states to the southern states and western states. New York, Massachusetts, Pennsylvania, Ohio, Michigan, and Illinois observed significant net loss of physicians; whereas Florida, California, Arizona, and Washington observed significant net gain of physicians. Specialists, younger, and female physicians are more likely to migrate.

Implications: The study identifies patterns of physician inter-state migration in the U.S. Understanding the factors that affect physician migration tendencies may help policy makers to create incentives and policy tools to ameliorate the maldistribution of the physician workforce.