Analysis finds too few kids’ doctors in certain places

MONDAY, DEC. 20, 2010

Redistribution could ensure care for all

CHICAGO – There are enough children’s doctors in the United States, they just work in the wrong places, a new study finds. Some wealthy areas are oversaturated with pediatricians and family doctors. Other parts of the nation have few or none.

Nearly 1 million kids live in areas with no local children’s doctor. By moving doctors, the study suggests, it would be possible for every child to have a pediatrician or family physician nearby, said lead author Dr. Scott Shipman of the Dartmouth Institute for Health Policy and Clinical Practice in Lebanon, N.H.

“I worry that it could get worse,” Shipman said.

He said medical schools are graduating more students, but the result will be more doctors in places where there’s already an over-supply.

Growth in the number of pediatricians and family physicians has outpaced increases in the U.S. child population, Shipman and his colleagues found. Yet the study’s analysis shows nearly all 50 states have extremely uneven distribution of primary care doctors for children.

The study used national data to calculate the per-child supply of working pediatricians and family physicians in geographic regions. Regions with many children’s doctors were wealthier. Low-supply regions were mostly rural.

The study appears today in the journal Pediatrics.

The number of pediatricians has been on the rise, increasing by 51 percent from 1996 to 2006. The supply of family doctors grew by 35 percent in the same years. The population of children grew by only 9 percent during those years.

Federal funding has expanded in recent years for the National Health Service Corps, which offers loan forgiveness for doctors and other practitioners who locate in underserved areas. That may help, Shipman said.

Don’t look for help from state governments, said Dr. Roland Goertz, a family physician in Waco, Texas, and president of the American Academy of Family Physicians, who wasn’t involved in the new study.

“Most states are in fiscal crisis. Without resources, it’s going to be tough to turn it around,” Goertz said.


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