"*- - "' PHYSICIAN PROFILE &.: ~ ; ~ 9 ,pae. ~wuTe-~,,c$,* !S.!~.oIw"aarddthe Year ., . T-r,k 2000' @.+,. , PREPARED BY THE J O N BOARD OF FAMlLY PRACTICE - STATE OF GEORGIA Active Non-Federal Phvsician-s- per 100,000 population' Poor A periodic examination of the geographic distribution of physicians in Georgia offers an important tool for: 1) identieing areas of need; 2) planning for health s e ~ c e s3;) locating facilities and; 4) monitoring the number of practicing physicians available. The current maldistribution of physicians shown in this overview is clear at the national and state levels. An examination of the distribution of physicians in Georgia by specialty, distinctly reveals an inadequate supply to meet the needs of this state's growing population. In 1992,there were not enough physicians in most Georgia counties to meet the demand for medical services. The estimated population for the year 2000 will be 7,703,202,an increase of 981,339from 1992. Applying the Graduate Medical Education National Advisory Committee (GMENAC) standard of 191physicians per 100,000persons, an additional 3,700medical doctors will be needed to provide servicesto the people of Georgia by the year 2000. I ' In 198!, Georgia ranked 36tl (,' among ali: &'; sIt- ate-s. 1 -- I Family Pediatrics Internal P----*I - I TOTAL I Between 1986 & 1992 in Georgia: The number of practicing subspecialty lo,000 physicians increased 18.7%while the number of Internists decreased 33.7%. k There was little or no change in the 8,000 number of practicing Family Practice, Pediatric, OBIGYN, and General Surgery physicians. 6,ooo There was a 30.3% decrease in the rate ofInternistsinurban areas, withthetotal 4,000 rate decreasing 24%. There was, however, a slight increase in the rate of Internists in rural areas. 2,000 The total physician rate in Georgia is 12.6%below the GMENAC standard of 191 physicians per 100,000 persons. o However, for 1990and 1992urban areas of the state were above the GMENAC standard. *RATE PER 100.000 POPULATION Internal Medicine Above Standard i I l I In 1992, Georgia'sphysician rate p a 100,000 persons was 164; compared to rate of 156 in 1990. m Y'SICIANS INGEORGIA, 1986,1990 & 1992 NUMBER BY SPECIALTY was: A major increase in the number of sub-specialties. A decrease in the number ofInternists;however, a slight increase occurred between 1990 and 1992. A total increase of 2,039 practicing physicians in Georgia - TOTALPHYSICUNS BY SPECIALTY, GEORGU, 1992 Number and Rate I AbaomiDat surgery Adolescat Medicine AerospaceMedicine Nergy Allergy and Immunology Anesthesology Bloodbanking CardiovasCuhDiseases Cardiovascular surgery Child Neurology ChildPsychiatry Clinical Pathology Clinical pllamwlogy colon and Rectal surgery Dennatology -logy Diaktes Diagnostic Radiology Emergency Medicine Endacrinology FamilylGenemlFhctice Forensic Pathology Gastnxnterology Generalm t i v e Medicine ~ e ~ e rsaurlgery GeTalics -logy Hand surgery Head and Neck Surgery Hematotogy Hypnosis Immunology Infectious Disease Internal Medicine Legal Medicine Maxillofacial Surgery N-lw Neonatal-Perinatal Medicine Neoplastic Diseases Nepb1ogy Neurological Surgery Neurology Nuclear Medicine Nuclear Radiology Nutrition obstetrics and Gynecology obstehics cxqmtioaalMedicine -logy Oph-logy o e d i c surgery other oto1ogy otorhino~ology Pathology Pediatrics Pediatric Allergy Pediatric Endocrinology Pediatric Hematology-Oncology Pediatric Nephrology Pediatric Radiology Pediatric Surgery Physical Medicine and Rehab. Plastic surgery Psychiatry Psychdlysis Psychosomatic Medicine Public Health Pulmonary Diseases Radiology Rheumatology Rhinology Therapeutic Radiology Thoracic Surgery Traumatic Surgery Urnlogical Surgery ] STATE TOTAL 11,014 RANK ORDER OF TOP 10 SPECIALTIES, GEORGIA, 1992 Number, Rate, and Practice Counties* * Repambthenumberofd e sfor that practicerpcci.lty. For example,Family Physicianspracticein 147o f h 159 a 12 witbout a FamilyF l w i h e r . FAMILY PRACTICE PROFILE i An Analysis of Family Practice I i Physician Need for 1992 Based on Standard Ratio of 1:3,000 Between 1986 and 1992 the number of Family Practice physicians increased by 12%. -Between 1986and 1992an averageof 12 Family Practice physicians per year were added to the supply, resulting in a rate of 23 physicians per 100,000 persons. To meet the standard of one Family Practice physician per 3,000 persons, at least 1,054 additional physicians are needed by the year 2000 (an increase of approximately 132 physicians a year). In 1992, there were 39 counties not needing additional Family Practice physicians. Counties Not Counties Needing Needing More More Family Family Physicians physicians _ . a -- Supply vs. Requirements ! The distribution of Family Practice physicians in Georgia distinctly reveals an inadequate supply to meet the needs of this state's growing population. There were not enough Family Practice physicians in most counties of Georgia to meet the 1992 demand for medical services. Moreover, the Georgia population for the year 2000 is projected at 7,703,202, an increase of 981,339 over 1992. Applying the Graduate Medical Education National Advisory Committee (GMENAC) standard of one Family Practice physician per 3,000 persons, a total of 2,568 doctors will be needed to provide family practice servicesto the people of Georgia by the year 2000. Currently, there are 1,s 14 Family Practice physicians in Georgia. PHYSICUN NEED Between 1992and 2000,a 69.9% increase in Family Practice physicians is needed. Counties are ranked according to the need (2000objectiveminus 1992supply). Cobb County will need an additional 125 Family Practitioners by the year 2000,making it the county of greatest need in Georgia. I Currently, there are 12 counties without a L Family Practice physician. Further, these 12 d e s could be considered as having a greater needthan the counties which do have a physician, but show a deficit. 1992 SUPPLY 2000 OBJECTIW -1 Physician Need (by Area) LUU~Y 1 1 IYUMBER Ok 2000 199i POP-ULATION COUNTIES OBJECTIVE (minus) SUPPLY STATE r uI'AL 159 2568 - 1514 - -0 9,999 - 10,000 19,999 - 20,000 49,999 - 50,000 149,999 Over 150.000 TOTAL Albany Athens Atlanta Augusta Chattanooga Columbus Macon 4 1 1772 2 4 1 3 50 20 1253 2 101 3 43 3 79 5 105 3 100 920 - 14 35 550 = - - - - 27 15 703 82 22 71 96 50 = - - - - - - - 19 21 8 9 50 TOTAL Northwest Northeast Central Southwest Southeast 118 796 16 17 42 22 21 176 136 175 144 165 - - - - - 139 - - 106 - 139 - 109 - 101 . 37 30 36 35 64 NUMBER OF FAMILY PRA CTZCE PHYSZCL4NS +No.. +oneto Four 11 dEm ivetoNine eater than Nine Of the 2,568 Family Practice physicians needed by the year 2000, 1,772 or 69 %will be required in the metropolitan areas. In the ~hantaMetropolitan Statistical Area, 1,253 Family Practice physicians will be needed. The non-metropolitan areas will need atotal of 799 Family Practice physicians or 31 % of the total need. - - FAMILY PRACTICE PHYSICIANS (BY SEX) Male Eamnl.. DEMOGRAPHICS FAMILY PRACTICE PHYSICIANS (BY AGE) The average age of Family Practice Physicians in Georgia is 49, whereas two years ago (1990) it was 50 and six years ago (1986) it was 48. Between 1986 and 1992, in metropolitan areas the average age of Family Practice Physicians increased fiom 46 to 47. In non-metropolitan areas, the average age remained the same at 50 years. There are 12 counties with no Family Practice Physicianslisted. However, it is possible some physicians do provide s e ~ c etos those countieswith no resident physician. Family Practice physicians practicing in 35 counties (22%) are equal to or above an average age of 55. FAMILY PRACTICE PHYSICIANS (BY RACE) ,& ls*i;d White 76.6% The percentage of white Family Practice physicians in urban and rural areas changed very little between 1986 and 1992. Other 0.6% I In i990 to 9% in 1992. In 1992, there are more black Family Practice physicians practicingin uhan rather than.rural areas. FAMILY PRACTICE PHYSICIANS ACCEPTING - I I The percentage of Family Practice physicians accepting Medicaid, Medicare and OB patients was higher inruralareasthaninudmareas. A higher percentage of Family Practice physicians acceptedMedicare thanMedicaid patients in urban areas,whereas in ruralareasthe percentage of Medicaid andMedicarepatient differential is not as great. There has been a continuousincrease in the number of Medicaid and Medicare patients acceptedby Family Practice physicians, and a decrease in the number of Obstetric patients seen by Family Practice physicians. b NUMBER OF PHYSICIANS BY SPECIALTY PRACTICING IN MORE THAN ONE COUNTY, 1992 * Number and Percent of Total (Rank) Forensic Pathology Psychommatic Medicine Pediatric Radiology Therapeutic Radiology AlhzY Hematology Neonatal-Perinatal Medicine Nuclear Medicine Nephrology Diagnostic Radiology Cardiovascular Diseases Radiology Urnlogical Surgery Otorhinolaxyngology Infectious Disease Physical Medicine and Rehab. Neurology Psychiatry Thoracic Surgery Emergency Medicine Neurological Surgery Allergy and Immunology Psychoanalysis Orthopeaic surgery Ophthalmology Pathology Gastmenterology Plastic Surgery * Specialtiesarenot listediflessthanfivephysicianspracticein multiplecountiea 32.5 30.6 1 Oncology I30.3 ChildPsychiatry 29.9 Gynecology 22 22.7 1 INTERNAL MEDICINE PROFILE (19921 COUNTIES WITHOUT + . AN :+2$ ~TERJJJIST - 2, ,. i ...,.A? Of the top twenty counties by number of Internists, only six counties are in rural areas. In Georgia, 58 of the state's 159 counties do not have an Internist practicing I11-time in the county. Applying the GMENAC standard of one Internist per 3,500 persons, a total of 2,201 doctorswill be needed in Georgiaby the year 2000. Between 1986 and 1992, the number of Internists in Georgia decreased 19%. To meet the GMENAC standard by the year 2000,12 1 more Internists will need to be added each year. INTERNAL MEDICINE INTERNAL MEDICINE PHYSICIANS (BY SEX) NUMBER (1992) - PERCENT * (1992) * Percents are adjusted to number of responses. 0 Urban Rural STATE TOTAL - MEDICINE NEED (by Area) NUMBER OF 2000- 1992 159 2201 - 1233 - Total NUMBER munun I EE!E! ~ v e r 150,600 8 960 815 - 145 TOTAL Albany Athens Atlanta Augusta Chattanooga Columbus Macon Savannah TOTAL Northwest Northeast Central Southwest Southeast 118 682 - 235 - 16 17 42 22 2 1 151 117 150 123 141 - - - - 57 - 34 54 - - - 43 47 - - - 94 83 % 80 94 PEDIATRICS L'UUNTIES WITHOUT .k - $ : A PEDIATRICIAN f' Ofthe top twenty counties by number of Pediatricians, only six counties are in rural areas. In Georgia, 94 of the state's 159 counties do not have a Pediatrician practicing I11-time in the county. Applying the GMENAC standard of one Pediatrician per 8,000 persons, a total of 962 doctors will be needed in Georgia by the year 2000. Between 1986 and 1992, the number of Pediatricians in Georgia increased 11%. To meet the GMENAC standard by the year 2000, approximately31Pediatricianswill need to be added each year. PEDIATRICIANS (BY SEX) 80 NUMBER (1992) * Percents are adjusted to number of responses. 0 Urban Rural Total PEDIATRIC NEED (by Area) STATE TOTAL -0 9,999 - 10,000 19,999 - 20,000 49,999 - 50,000 149,999 Over 150.000 COUNTIES 159 LUW OBJECTIVE 963 (minus) - 1992 SUPPLY 713 (equals) - - NEEDED d Albany Athens Atlanta Augusta -wga Columbus Macon TOTAL Northwest Northeast Central Southwest Southeast 118 299 - 117 = GENERAL SURGERY b COUNTIES WITHOUT A GENERAL SURGEON I PROFILE (1992) Jo General Surgwm GENERAL SURGERY GENERAL SURGEONS (BY SEX) 120 NUMBER (1992) 1 * Percents are adjusted to number of responses. 0 Urban Rural Total GENERAL SURGEON NEED (by Area) STATE TOTAL, 159 -0 9,999 - 10,000 19,999 - 20,000 49,999 - 50,000 149,999 43 45 41 22 Over 150.000 8 TOTAL, Albany 2 Athens 3 Atlanta 20 A- 2 Chikmooga 3 Columbus 3 Macon 5 Savannah 3 TOTAL Northwest Northeast 17 Central Southwest 22 Southeast 2 1 770 - 580 - 30 71 138 195 336 - - - - - 9 - 27 - 88 - 154 302 - - - 21 44 50 41 34 12 15 376 30 13 24 31 30 - - --.-- 12 11 259 52 4 15 35 29 - - - - - 0 4 117 -22 9 9 -4 1 4 1 52 43 50 - - - - 26 36 31 35 - - - - - - - 15 16 12 , 15 OBSTETRICS & GYNECOLOGY PROFILE (1992) OBSTETRICSAND GYnECOLOGY OBIGYN PHYSICIANS (BY SEX) * Percentsare adjustedto number of responses. 0 Urban Rural Total OBIGYN NEED (by Area) POPULATION STATE TOTAL COUNTIES 159 OBJECTIVE (minus) 770 - SUPPLY 682 (equals) - NEEDED I Albw Athens Atlanta Aususta c-ga Columbus Macon Savannah TOTAL Northwest Northeast Central Southwest Southeast PHMARY CARE PHYSICIANS BY SPECIALTY BY COUNTY, GEORGIA, 1992 Number, Rate and Rank I PAM.IOEN. PMCTK!E 8 IUn21-3 PRIMARY CARE JNTERNALMWCINE 8 IuTBIUWI NUMBER OF PHYSICIANS 1 1 PEDlATRICS OBIGYN 8 IUTEIi*YI I I U T E I M GMERAL SURGERY mA1S 8 IRATEIRANK 8 PRlMARY CARE (corn., Ckybn Cliach Cobb Coffee Colquia CoMm Cook Cwea Cnwfold c* I FAUSEN. PRACIlCE 1 1 19 10.02 137 6,127 2 32.64 36 479.750 78 16.26 117 30.538 8 26.20 69 36,983 10 27.04 63 71,011 7 9.86 138 13.615 4 29.38 49 56.750 7 12.33 129 9,177 1 10.90 135 20,349 6 29.49 48 PRIMARY CARE lNTEuNALt.4EDmNE NUMBER OF PHYSICIANS PEDIATFXS 27 14.24 39 25 13.18 0 0.00 102 0 0.00 66 13.76 42 54 11.26 2 6.55 81 2 6.55 4 10.82 56 1 2.70 3 4.22 97 2 2.82 0 0.00 102 0 0.00 9 15.86 34 6 10.57 0 0.00 102 0 0.00 4 19.66 18 1 4.91 10 14 66 0 19 39 42 2 62 2 60 1 66 0 25 3 66 0 51 2 0mYN 7.38 39 0.00 65 8.13 36 6.55 46 5.41 55 1.41 63 0.00 65 5.29 56 0.00 65 9.83 28 GENERAL SURGERY 16 8.44 49 0 0.00 89 30 6.25 63 3 9.82 36 3 8.11 52 3 4.22 7'7 0 0.00 89 7 12.33 21 0 0.00 89 2 9.83 35 lx7rAl.S I 246 2 652 27 45 26 4 61 1 22 PRIMARY CARE cconr., PAMNEN. PRAmlCE PRIMARY CARE INITRNALHEDWK NUMBER OF PHYSICIANS 1 PEMATRICS OBXim GENERAL. SURGERY TCWACE I PRlMARY CARE (COM., TON PRIMARY CARE I "2 I 1 FAMJGEN. PRACWE # .m3 INTERNU MEDICINE # M PEDlATRlCS , 1 1E OWYN I I PRIMARY CARE (COM.) FAMXEN. PRACIICE PRIMARY CARE m M . MEDICINE PEDIATRIC5 OBIGYN RATE RANK I RATE RANK X GMWULSURGERY I 1 TUTU I METROPOLITAN STATISTICAL AREAS (MSA). 1992 somcm: u Joint Board of Family Practice, f i y h R OTmw~rdthe Year 2000,March, 1991. JointBoard of Family Practice, Family R& f i y d a n Rofrle, T-d the Year2000. JointBoard of Family Practice, OO&/GI?Vfiyh Rofrle, T-d the Year2000. State CompositeBoard ofMedim1h m i n e r s , 1992Physician Licenses data. JointBoard ofFamilyPractice, State Board ofMedicalEraminersand GeorgiaDeparbnent of Human Resouas, Georgiaf i p b Survey, 1990, Septembec 1990. JointBoard ofFamilyPractice, Qualityo f l g e and theDkbibution of fiysicians in Georgia:A Disturbing Pwadbx,Decembec 1989. GeorgiaO f J e of Planning and Budget, 1990 Census Countsand 2000 Population R o ~ n s . U.S. Deparbnent of Health andHuman Services, &Graduate M e d i d Eh&n NaiionalAdvisory Commitfee(GMENAq Summary Repo* Washington,D.C. U.S. GovernmentPrinting Omce, 1980. U.S. Deparhnent ofHealth andHumanServices, and Centersfor Disease Conhl, Heah%,UnitedSratks, 1991and Revention Rofrle, Table 96, pp. 243-244. ACKNOWLEDGEMENTS: Appreciationto Michael R. Lavoie, Division ofpublic Health;Andrew Watry,State CompositeBoard ofMedical Examiners, for theirreview and support of these efforts; Dr. G.E.Alan Dever, MercerUniversity School of Medicine; and Donna M. Brantley, Joint Board of Family Practice. Joint Boara of Family Practice 2 Northside 75, NW, Suite 230 Atlanta, Georgia 30318-7701