260792 Inter-state Migration Pattern of Physicians, 2000 to 2010

Wednesday, October 31, 2012 : 12:50 PM - 1:10 PM

Imam M. Xierali, PhD , Robert Graham Center, AAFP, Washington, DC
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.

Learning Areas:
Provision of health care to the public
Public health or related public policy
Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe the health workforce geographic maldistribution in the US and identify patterns of physician inter-state migration

Keywords: Access to Health Care, Workforce

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a Health Geographer and Research Scientist at the Robert Graham Center. Previously, I was a Statistical Analyst at Georgia Division of Public Health. My research interests are in spatial disparities in health and health care, geospatial technologies for health applications, statistical modeling and spatial statistics. I am particularly interested in the relationship between health workforce distribution and health outcomes.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.