Doctor Shortage: Which States Have the Fewest & Most Doctors Per 100,000 People?

A new survey conducted by the research firm 2/7 Wall St has identified the 10 U.S. States that have the fewest doctors per 100,000 people in the population, versus the 10 States that have the most doctors per 100,000 people.

A comparison of these States shows a stark contrast in terms of life expectancy of the population, and other key factors.

This analysis is of great significance to the nation’s healthcare system, as a whole, as “The U.S. is currently facing a severe shortage of doctors,” the survey authors point out.

“The Association of American Medical Colleges predicts that by 2020, the shortage will amount to more than 90,000 doctors, including 45,000 patient care physicians.”

According to the survey authors, the impending national doctor shortage is due to several factors, including primarily demographics. The aging baby boom generation will require more medical care in coming years. And, under the Patient Protection and Affordable Care Act, more people will obtain health insurance, which is expected to lead “millions more to seek care.” Yet, “a third of all doctors plan to retire this decade,” according to the survey authors.

The new survey, written by Samuel Weigley, Alexander E.M. Hess and Michael B. Sauter of 24/7 Wall St, identified the States with the most and fewest doctors per 100,000 people based upon data from the American Association of Medical Colleges’ State Physician Workbook Data Book, for 2010 (the most recently available data).

The authors also compared the States based upon income, poverty and health insurance data from the U.S. Census Bureau, as well as data on life expectancy, obesity and other health factors from The Henry J. Kaiser Family Foundation.

The Ten States With The Fewest Doctors:

Here is a summary of the survey findings as to the 10 States with the Fewest doctors per 100,000 residents:

More detailed information on each of these States is found in the new survey report.

The Ten States With The Most Doctors:

Here is a summary of the survey findings as to the 10 States with the Highest number of doctors per 100,000 residents:

More detailed information on each of these States is found in the new survey report.

Findings Based on a Comparison of States

The 10 States with the Highest and the 10 States with the Lowest number of patient care doctors per 100,000 people are listed below. Massachusetts, with the highest number of doctors per 100,000 people, had 314.8 patient care doctors for every 100,000 residents. On the other hand, Mississippi had just 159.4, or just half the figure for Massachusetts.

In comparing the 10 states with the highest ratio of patient care physicians and the 10 states with the lowest, the survey authors found stark differences.

“The states with the most patient care physicians per capita also tend to be healthier states, and vice versa,” the authors observed, citing information provided by AAMC’s chief policy officer Atul Glover. “[A]ll but one state in the top 10 had a longer life expectancy than the country’s 78.6 years, with four of the states in the top 10 for life span. Meanwhile, all but two states in the bottom 10 had a shorter life expectancy than the national average, with five of the states in the bottom 10 for life span,” the authors found.

They also noted that “States with high doctor-to-resident ratios tend to have lower smoking rates and fewer people who are either overweight or obese than those with low doctor-to-patient ratios.”

With doctor to patient ratios correlating so significantly to human health and longevity, it is remarkable and unfortunate that the survey also found evidence suggesting that the number of doctors a state can attract appears to be economically driven.

“Generally, the states with high median incomes tend to have more doctors per capita, while poorer states tend to have substantially fewer,” the authors concluded. “Among the 10 states with the most practicing physicians per capita are five of the six wealthiest states by median income in the country,” they observed.

“The ability to pay has a major influence on whether people have health insurance. Each of the 10 states with the highest concentration of doctors has uninsured rates lower than the national rate of 15.5%, while seven of the 10 states at the bottom have uninsured rates higher than the national rate,” the authors note. “When doctors treat insured patients they are paid more than when they treat uninsured patients, incentivizing them to move to highly insured states,” they conclude.

“Most of [the uninsured] are choosing to not get insurance because they can’t afford it, and so you’re not likely to get paid, at least paid fully, from those patients,” AAMC’s chief policy officer Atul Glover told 24/7 Wall St.

Mr. Glover told the authors that “although the new federal health law will expand Medicaid coverage, the program, along with Medicare, tends to pay physicians between 30% and 40% less than private insurance companies.”

In addition, the authors found a larger number of medical students performing residencies in the states with highest doctor-to-patient ratios, as well as more ample medical facilities. “Six of the top 10 states are in the top 10 for the number of medical residents per 100,000 people,” while “six of the bottom 10 states are in the bottom 10 for medical residents,” the authors found.

Conclusions

“Both medical schools and governments are trying to find solutions for the shortage of doctors. Some medical schools are expanding enrollment, although that is difficult to accomplish due to cutbacks in federal funds. Others state governments are considering programs that would pay patient care doctors to go to underserved areas for designated periods of time. This is similar to the National Health Service Corps., which will help pay off medical school loans for graduates who go to certain underserved states for two to four years,” the authors note in conclusion.

The Patient Protection and Affordable Care Act, the new U.S. health care law, also contains several provisions addressing the impending doctor shortage. The Act contains provisions aimed at increasing the supply of primary-care physicians, for example, by augmenting their Medicare and Medicaid fees and by helping to pay their educational debt. In addition, a number of initiatives emphasizing expanded focus on primary care are being implemented under the Act. [See reports by HelpingYouCare^® cited below.]

More Information

The new survey report is available in its entirety on the website of 24/7 Wall St.

See also America’s Best (and Worst) Educated States, another report by 24/7 Wall St.

See related HelpingYouCare^® reports on:

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