Low physician density does not impair access,unless you're uninsured
How Adults’ Access to Outpatient Physician Services Relates to the Local Supply of Primary Care Physicians in the Rural Southeast
By Donald E. Pathman, Thomas C. Ricketts III, and Thomas R. Konrad
HSR
February 2006
Objective: To examine how access to outpatient medical care varies with local primary care physician densities across primary care service areas (PCSAs) in the rural Southeast, for adults as a whole and separately for the elderly and poor.
Conclusions: For adults as a whole in the rural South and for the elderly there, low local primary care physician densities are associated with travel inconvenience but not convincingly with other aspects of access to outpatient care. Access for those insured under Medicaid and the uninsured, however, is in more ways sensitive to local physician densities.
From the Implications: If the importance of local primary care physician availability to access in rural areas is minimal, then increasing local physician numbers is not the appropriate policy response when access indicators for a community are poor. Poor access indicators most often suggest the need to make health care more affordable.
http://www.blackwell-synergy.com/doi/abs/10.1111/j.1475-6773.2005.00454.x
Comment: By Don McCanne, M.D.
It is reassuring to note that, except for travel inconvenience, low density of primary care physicians has little impact on impairing access. What should alarm us is that being uninsured or being insured by the inadequately funded Medicaid program does have a negative impact on access in low desity regions.
Is there really anyone out there who still believes that we should continue to reject national health insurance because it is not politically feasible? It seems that inaction is what is no longer feasible.