PHYSICIAN WORKFORCCEE** Core Speciallttiieess **BBaasseed on 2006 LiceennssuurreeDDaattaa GGGGeeeeoooorrrrggggiiiiaaaa BBBBooooaaaarrrrdddd ffoorr PPhhyyssiicciiaannnn WWWWoooorrrrkkkkffffoooorrrrcccceeee SSSSDDDDtttteeaaeeacctteeeemmooffbbGGeerreeoo2200rrgg00ii8888aaaa Executive Summary The 2006 Physician Workforce Profile marks the 20th year the Georgia Board for Physician Workforce (previously the Joint Board for Family Practice) has examined the supply and distribution of Georgia's physicians using data from license renewals. The physician data is analyzed by the GBPW and the resulting information is then reported on a biennial basis. This information is important in determining trends in workforce patterns (i.e. demographics, specialty, and geographical location) and to better monitor the healthcare needs of Georgia's citizens. In 2006, more Georgia physicians were in specialized categories. At the same time, the workforce also experienced a decrease in primary care. This same trend has been noted across the country. The largest decrease in generalists occurred between 2004 and 2006 in Georgia. Between 1996 and 2006, the population in Georgia increased by 26.4%. The rate of physician increase between 1996 and 2006 was 33.1% (slightly higher than the population increase). The rates for family practice, internal medicine, pediatrics, OB/GYN and general surgery all decreased between 2004 and 2006. The percentage of physicians practicing "other specialties" was the highest in 2006. In 2006, Georgia experienced the largest decrease in generalist physicians (family practice, internal medicine, and pediatrics) from the previous cycle (37.3% in 2004 vs. 34.8% in 2006). In 2006, the rates of physicians in Metropolitan Statistical Areas (MSAs) were higher than in Non-Metropolitan Statistical Areas (Non-MSAs) in all of the core specialties (internal medicine, pediatrics, OB/GYN, and general surgery) except for family practice. Fifty-two percent of all Georgia's physicians are located in five Primary Care Service Areas (PCSAs). These five PCSAs represent 37.9% of the state's population. Physician workforce demographics are important to note, as research has concluded that demographics play an important role in geographic distribution and hours worked per week. Of the five "core" specialties, pediatrics has the highest percentage of female physicians. This is the only specialty where females constitute >50% of the workforce. General surgery has the lowest percentage of females (8.3%). Female pediatricians are also more likely to be located in non-MSAs than female physicians in any of the other five core specialties. The percentage of "White" physicians has decreased by 7.7% since 1996. The percentage of "Black/African American", "Asian", and "Other" physicians has increased between 1996 and 2006. The physician workforce is aging. In 2006, 26.3% of the physician workforce was 55 and over. In 1996, 23.6% were 55 and over. Of the five core specialties, general surgery had the largest percentage (31.5%) of physicians age 55 and over. Family practice had the second highest percentage of physicians 55 and over with 30.8%. Pediatrics had the youngest cohort of physicians, with 16.0% being less than 35 years old. There was a slight decrease in the percentage of physicians accepting Medicaid and Medicare between 2004 and 2006. Also in 2006, almost 30% of physicians said they are not accepting new Medicaid patients and 23.6% are not accepting new Medicare patients. PHYSICIAN PROFILE 2006 Distribution of Physicians, U.S. 2006* per 100,000 population Excellent Good Fair Poor In 2006 Georgia ranked 39th among all states. * Source: American Medical Association, Physician Characteristics and Distribution in the U.S. 2008 Edition. 2006. Rankings are quartiled. Does not include District of Columbia. Monitoring the supply and distribution of physicians by specialty and geographic location provides beneficial information to: (1) determine funding for graduate medical education, (2) identify areas of need, (3) plan for health services, (4) locate facilities, and (5) monitor and evaluate the number of practicing physicians. This latest workforce analysis indicates continued problems with physician distribution. For example, some areas of the state have an adequate or surplus supply of certain primary care physicians, while other areas have a deficit. There have been major changes in the growth of the population and of the physician workforce. Between 1996 and 2006, the population in Georgia increased by 26.4%. The rate of physician increase during the same years was 33.1% (slightly higher than the population increase). To illustrate how Georgia compares to other states, Georgia's physician rate per 100,000 population was 202 for 2006 and the national rate was 303 physicians per 100,000 population. Physician Supply in Georgia 1996-2006 Physicians in Georgia - Number Georgia's Physician Supply - Rate* Number 13,845 14,739 15,736 16,483 17,513 18,422 Rate 25,000 20,000 15,000 10,000 5,000 0 1996 1998 2000 2002 2004 2006 250 192 200 193 192 193 202 202 150 100 50 0 1996 * Rate per 100,000 1998 2000 2002 2004 2006 1 PHYSICIAN SPECIALTIES IN GEORGIA Specialty Georgia Board for Physician Workforce 2004 & 2006 Selected Specialties by MSA / Non-MSA Designation 2004 MSA Non-MSA Number Rate* Number Rate* 2006 MSA Non-MSA Number Rate* Number Rate* Family Practice 1,633 23.4 660 38.4 1,835 24.8 556 32.3 Internal Medicine 2,122 30.5 530 30.8 2,109 28.5 362 21.0 Pediatrics 1,309 18.8 279 16.2 1,371 18.6 177 10.3 OB/GYN 1,027 14.7 254 14.8 1,145 15.1 146 8.5 General Surgery 579 8.3 154 9.0 582 7.9 117 6.8 *Rate per 100,000 population Generalists vs. Specialists The percentage of "other specialists" increased the most between 2004 and 2006 with 55.8% of the physician population being "other specialists". Rates for family practice, internal medicine, pediatrics, OB/GYN and general surgery all decreased between 2004 and 2006. The percentage of "other specialists" decreased steadily from 1996 to 2002. A slight increase occurred from 2002 to 2004 and then a larger increase was seen between 2004 and 2006. The percentage of generalists was the lowest in 1996. Historically, the largest decrease in generalists occurred between 2004 and 2006. Number 18,000 16,000 14,000 12,000 10,000 8,000 6,000 4,000 2,000 0 Generalists Specialists Percent of Generalists & Specialists by Year 1996-2006 55.5% 5.0% 6.4% 7.0% 12.4% 13.7% 53.2% 4.8% 6.1% 8.7% 13.4% 13.8% 51.9% 4.9% 6.3% 8.9% 14.4% 13.6% 51.2% 4.4% 6.9% 9.1% 15.2% 13.2% 51.8% 4.2% 6.7% 9.1% 15.1% 13.1% 55.8% 3.8% 5.6% 8.4% 13.4% 13.0% 1996 1998 2000 2002 2004 2006 Other Specialties General Surgery OB/GYN Pediatrics Internal Medicine Family Practice 2 PHYSICIAN RATE DISTRIBUTION OF PHYSICIANS BY PCSA* DADE CATOOSA 1** 2 WHIT- FIELD FANNIN 4 3 UNION 5 TOWNS 6 RABUN 7 WALKER MURRAY GILMER WHITE HABERSHAM Excellent (>158) CHATTOOGA GORDON 16 PICKENS 14 LUMPKIN 12 DAWSON 11 STEPHENS 10 8 FRANKLIN HART 9 BANKS 28 Good (117 - 158) Fair (88 - 116.9) Poor (<88) FLOYD CHEROKEE FORSYTH HALL 18 17 15 13 BARTOW JACKSON ELBERT MADISON 21 27 29 POLK PAULDING COBB 25 HARALSON GWINNETT DEKALB BARROW CLARKE OGLETHORPE OCONEE WALTON WILKES LINCOLN 19 20 22 23 24 26 30 31 CARROLL 41 4039 38 36 35 34 32 HEARD DOUGLAS FULTON ROCKDALE NEWTON MORGAN GREENE TALIAFERRO MCDU- COLUMBIA CLAY- FFIE COWETA FAYETTE TON HENRY SPALDING BUTTS JASPER PUTNAM WARREN HANCOCK GLASCOCK RICHMOND 37 33 BURKE 42 MERI- TROUP WETHER PIKE LAMAR MONROE JONES 44 45 UPSON BIBB 46 BALDWIN 47 JEFFERSON 49 WASHINGTON WILKINSON 48 JOHNSON 50 JENKINS 54 SCREVEN 51 HARRIS TALBOT CRAWFORD TWIGGS EMANUEL 43 MUSCOGEE MARION CHATTAHOOCHEE STEWART WEB- TAYLOR PEACH 67 HOUSTON MACON BLECKLEY 63 57 LAURENS 60 TREUTLEN 55 CANDLER 53 BULLOCH EFFINGHAM SCHLEY 68 66 DOOLY PULASKI 64 DODGE 62 MONTGOMERY- 59 WHEELER 58 TOOMBS 56 EVANS TATTNALL BRYAN 52 CHATHAM 69 STER SUMTER QUITMAN 70 TERRELL LEE RANDOLPH WILCOX 65 CRISP TURNER BEN HILL 87 TELFAIR 61 JEFF DAVIS 89 APPLING 91 LIBERTY LONG 92 76 CLAY CALHOUN DOUGHERTY EARLY WORTH 77 79 TIFT IRWIN 86 85 COFFEE 88 71 BAKER MILLER 72 MITCHELL 78 COLQUITT BERRIEN ATKINSON 80 COOK 84 83 LANIER SEMINOLE CLINCH THOMAS DECATUR GRADY BROOKS LOWNDES 73 74 75 81 82 ECHOLS BACON 90 WAYNE MCINTOSH PIERCE 94 93 GLYNN BRANTLEY WARE CHARLTON 95 CAMDEN 96 Rates are per 100,000 population In 2006 Georgia's physician rate per 100,000 population was 202; compared to the rate of 192 in 1996. The distribution of physicians in Georgia is primarily concentrated in metropolitan areas. The top ten PCSAs are: 1. Area 31: Columbia, Lincoln, Richmond 2. Area 22: Fulton 3. Area 73: Decatur 4. Area 75: Thomas 5. Area 23: DeKalb 6. Area 47: Baldwin 7. Area 94: Pierce, Ware 8. Area 46: Bibb, Crawford, Jones, Peach, Taylor, Twiggs, Wilkinson 9. Area 60: Laurens, Treutlen 10. Area 52: Bryan, Chatham, Effingham, Liberty Fifty-two percent of all Georgia's physicians are located in five PCSAs. These five PCSAs represent 37.9% of the state's population. * Primary Care Service Areas (PCSAs) are included as a geography in the 2006 profile. Ninety-six (96) areas were designated by the 30% rule using the Georgia Hospital Questionnaire. A PCSA was designated if at least 30% of the patients received care in their county of residency. If a county received less than 30% of its residents as patients, it was assigned to the county where the majority of its residents go for primary care. Physicians in Georgia by Specialty 1996-2006 1,894 2,027 2,143 2,171 2,293 2,391 1,718 1,971 2,264 2,509 2,652 2,471 964 1,280 1,402 1,495 1,588 1,548 891 903 986 1,138 1,171 1,027 691 708 771 726 733 699 7,687 7,687 7,850 7,850 8,170 8,170 88,,444444 99,,007766 1100,,228866 3,000 2,500 2,000 1,500 1,000 500 0 Family Practice Pediatrics Internal Medicine 1996 2000 1998 2002 General Surgery OB/GYN 2004 2006 3 12,000 10,000 8,000 6,000 4,000 2,000 0 Other Specialties Specialty Georgia Physician Workforce: Specialty and Rate*, 1996-2006 1996 1998 2000 2002 2004 2006 Allergy & Immunology Anesthesiology Cardiovascular Diseases Dermatology Emergency Medicine Endocrinology Family/General Practice Gastroenterology General Surgery Gynecology Infectious Disease Internal Medicine Neonatal-Perinatal Medicine Nephrology Neurological Surgery Neurology Obstetrics/ Gynecology Oncology Ophthalmology Orthopedic Surgery Otorhinolaryngology Pain Medicine Pathology (all Pathologies combined for 2006) Pediatrics Physical Medicine & Rehabilitation Plastic Surgery Psychiatry Public Health Pulmonary Diseases Radiology (Diagnostic Radiology & Radiology combined) Rheumatology Therapeutic Radiology Thoracic Surgery Urological Surgery State Total** 0.98 10.22 5.45 2.98 7.84 1.00 26.27 2.73 9.59 2.51 1.37 23.83 0.77 1.51 1.54 3.37 12.25 1.69 5.17 7.62 2.86 Not Listed 4.40 13.37 1.31 2.03 11.42 1.60 2.03 9.29 0.83 0.97 0.49 3.44 192 0.83 9.84 4.83 2.94 8.41 0.86 26.52 2.55 9.26 2.66 1.32 25.79 0.23 1.41 1.53 3.35 11.82 1.57 4.92 7.20 3.02 Not Listed 4.41 16.75 1.45 1.87 11.04 1.52 1.92 8.97 0.76 0.86 0.42 3.42 193 0.87 9.56 4.73 2.98 8.94 0.77 26.18 2.65 9.42 2.23 1.20 27.66 0.31 1.28 1.34 3.19 12.04 1.58 4.75 6.79 3.11 0.17 4.51 17.13 1.45 1.82 11.14 1.16 1.92 9.10 0.75 0.67 0.43 3.04 192 1.24 8.93 4.28 2.88 8.81 0.80 25.36 2.10 8.48 1.41 1.56 29.30 0.71 1.43 1.39 3.22 13.29 1.75 4.64 6.89 2.88 0.79 4.43 17.46 Not Listed 2.13 10.45 0.80 1.67 8.32 0.60 1.06 1.08 3.06 193 1.31 9.52 4.75 3.16 9.62 0.89 26.40 2.38 8.44 1.26 1.71 30.53 0.86 1.70 1.48 3.48 13.48 2.08 4.67 7.04 3.12 0.79 4.55 18.28 0.28 2.31 10.53 0.86 1.89 8.50 0.72 1.09 1.08 2.97 202 0.98 9.06 6.74 3.01 9.61 1.44 26.24 3.60 7.67 2.89 2.26 27.12 1.25 2.62 1.50 3.31 11.27 2.57 4.70 7.47 3.07 1.24 3.80 16.99 1.40 2.29 11.15 1.25 2.92 8.60 0.96 1.40 0.74 3.04 202 * Rate per 100,000 population. Population for 1996-2006: Governor's Office of Planning and Budget (www.opb.state.ga.us). ** All physicians 4 R ater per 100,000 Physician Rates by Selected Specialties: 1996-2006 35 30 26.27 26.52 25 23.83 25.79 20 1 6. 75 15 1 3.37 1 1 .82 10 1 2. 25 5 9.59 9.26 0 1996 1998 27.66 26. 1 8 1 7. 1 3 1 2. 04 9.42 29.3 25.36 1 7. 46 1 3. 29 8.48 2000 2002 Year 30.53 26.4 1 8. 28 1 3. 48 8.44 2004 27.1 2 26.24 1 6. 99 11.27 7.67 2006 Family Practice Internal Medicine Pediatrics OB/GYN General Surgery DEMOGRAPHICS All Specialties 84.2 84.6 85.4 78.3 81.3 80.6 86.2 85.3 85.4 77.3 79.2 78.1 Accepting Medicare and Medicaid* 100% 80% 60% 40% 20% 0% Medicare 1996 1998 2000 2002 Medicaid 2004 2006 New Medicaid and Medicare Patients 2006 (Percent) Accept New Yes No Patients: New Medicare 76.4 23.6 New Medicaid 70.7 29.3 81.6 80.0 79.0 79.1 79.4 73.9 18.4 20.0 21.0 20.9 20.6 26.1 Gender 100% 80% 60% 40% 20% 0% Race Ma l e 1996 1998 2000 2002 2004 2006 Fe male 84.1 80.2 79.0 77.4 77.1 74.8 8.1 8.9 10.3 11.9 12.7 13.4 6.9 7.8 8.1 7.7 6.8 7.2 0.9 3.1 2.6 3.0 3.4 4.6 10 0 % 80% 60% 40% 20% 0% White Black As ian 19 9 6 2000 2004 19 9 8 2002 2006 Othe r 5 6 1996 1998 2000 2002 2004 2006 65 and Over 60-64 55-59 50-54 45-49 40-44 35-39 30% 25% 20% 15% 10% 5% 0% Less than 35 15.5 26.0 26.2 13.2 15.3 14.3 20.5 19.8 19.9 17.6 17.5 19.2 19.5 18.4 17.9 17.7 17.5 17.8 14.3 13.4 15.0 18.0 15.9 15.8 8.4 7.7 8.0 14.6 15.7 14.4 5.6 5.3 5.0 7.3 8.0 9.2 3.5 2.9 3.1 5.4 4.9 4.0 8.1 8.5 4.9 6.2 5.2 5.2 INTERNAL MEDICINE 1996 1998 2000 2002 2004 2006 65 and Over 60-64 55-59 50-54 45-49 40-44 35-39 12.5 15.4 15.6 11.9 14.0 11.0 17.2 16.5 16.0 12.9 14.5 17.4 19.8 19.2 18.0 15.1 13.4 14.0 15.5 14.9 16.6 18.2 17.6 15.6 11.4 11.2 12.0 14.9 14.9 15.8 8.8 8.7 8.6 9.1 9.6 11.4 6.1 6.2 6.0 5.4 5.3 10.7 8.7 7.9 7.2 12.3 10.7 8.7 30% 25% 20% 15% 10% 5% 0% Less than 35 FAMILY PRACTICE 1996 1998 2000 2002 2004 2006 65 and Over 60-64 55-59 50-54 45-49 40-44 35-39 30% 25% 20% 15% 10% 5% 0% Less than 35 12.5 15.4 15.6 10.2 12.9 11.3 17.2 16.5 16.0 1144..97 15.0 19.8 19.2 18.0 17.4 16.4 15.3 15.5 14.9 16.6 18.5 17.4 16.7 11.4 11.2 12.0 14.1 14.2 15.4 8.8 8.7 8.6 9.9 9.8 10.9 6.1 6.2 6.0 6.8 6.6 7.0 8.7 7.9 7.2 8.6 7.8 8.4 TOTAL PHYSICIANS DEMOGRAPHICS Distribution by Age and Specialty Specialties 7 1996 1998 2000 2002 2004 2006 65 and Over 60-64 55-59 50-54 45-49 40-44 35-39 30% 25% 20% 15% 10% 5% 0% Less than 35 10.5 13.7 19.8 10.6 13.0 11.8 14.6 15.1 14.4 11.1 12.3 13.0 17.1 16.2 14.9 14.8 14.4 13.5 12.8 12.4 12.8 15.9 15.7 16.0 11.9 11.3 10.5 11.9 12.6 14.2 11.6 11.5 9.2 11.1 10.8 11.2 7.9 8.8 8.6 10.6 9.5 9.1 13.6 9.711.0 14.0 11.5 11.2 GENERAL SURGERY 1996 1998 2000 2002 2004 2006 65 and Over 60-64 55-59 50-54 45-49 40-44 35-39 30% 25% 20% 15% 10% 5% 0% Less than 35 14.8 16.2 19.6 1114.7.0 11.9 19.6 18.8 17.4 16.6 17.3 18.9 18.9 20.6 18.7 18.1 16.9 18.1 14.3 13.1 14.6 17.1 16.8 16.6 13.6 12.5 11.1 11.8 12.3 13.1 8.4 8.2 9.1 10.9 9.5 10.6 4.8 5.7 4.6 6.4 7.0 6.6 5.6 4.8 5.0 7.4 6.3 4.2 OB/GYN 1996 1998 2000 2002 2004 2006 65 and Over 60-64 55-59 50-54 45-49 40-44 35-39 16.8 20.6 20.9 13.9 16.4 16.0 19.6 18.0 16.2 16.2 17.5 18.1 20.0 17.9 17.6 17.5 16.9 16.5 12.8 15.1 16.2 16.6 21.1 16.2 10.1 10.4 10.3 13.3 12.9 12.8 8.0 6.7 7.5 9.6 8.8 8.4 4.7 5.0 5.3 5.8 6.0 6.0 8.0 6.5 6.0 7.0 6.3 5.9 30% 25% 20% 15% 10% 5% 0% Less than 35 Distribution by Age and Specialty PEDIATRICS Specialties DEMOGRAPHICS FAMILY PRACTICE PROFILE - 2006 TOP 10 PRIMARY CARE SERVICE AREAS (PCSAs) BY NUMBER OF FAMILY PRACTICE PHYSICIANS RANK* 1. Area 22: Fulton (233)** 2. Area 23: DeKalb (153) 3. Area 25: Gwinnett (136) 4. Area 43: Chattahoochee, Harris, Marion, Muscogee, Talbot (130) 8 5 3 10 2 1 5. Area 21: Cobb, Paulding (129) 6. Area 31: Columbia, Lincoln, Richmond (127) 9 7. Area 52: Bryan, Chatham, Effingham, Liberty (107) 4 8. Area 18: Chattooga, Floyd, Polk (88) 9. Area 46: Bibb, Crawford, Jones, Peach, Taylor, Twiggs, Wilkinson (84) 10. Area 27: Barrow, Clarke, Jackson, Madison, Morgan, Oconee, Oglethorpe (74) * Numbers correspond to rank. ** Numbers in parenthesis respresent the number of physicians. 6 7 PIERCE Family Practice Physician Supply 3,000 2,500 2,000 1,894 2,027 2,143 2,171 2,293 2,391 Number 1,500 1,000 500 0 1996 2000 2004 1998 2002 2006 8 Between 1996 and 2006, the number of family practice physicians in Georgia increased 26.2%. In 2006, there was at least one family practice physician in every PCSA. The greatest increase in family practice physicians (in number) was between 1996 and 1998. The top 10 PCSAs for number of practicing family physicians are all located in Metropolitan Statistical Areas. Family Practice Family Practice Physician Distribution - 2006 Deficit, Adequate, and Surplus PCSAs* 6 Dade Catoosa Whitfield Fannin Towns Union Rabun 1 2 3 4 5 7 Walker 12 10 8 Deficit Chattooga 18 1167 1154 13 11 9 28 ASudrepqluuaste Floyd Murray Gordon Bartow Gilmer Lumpkin White Habersham Stephens Pickens Dawson Cherokee Forsyth Franklin Hart Banks Hall Jackson Elbert Madison 27 29 Polk Gwinnett Barrow Clarke 21Cobb 25 Paulding 23 Haralson Walton Oconee Oglethorpe Wilkes Lincoln 19 20 22 24 26 30 31 Carroll Douglas Fulton Dekalb Clayton- Rockdale Newton Morgan Greene Taliaferro Columbia McDuffie 41 40339738 36 35473433 32 50 Heard Fayette Coweta Henry Jasper Putnam Spalding Butts Warren Hancock Glascock Richmond Burke Meriwether Baldwin Jefferson Pike Lamar Monroe Jones Washington 42 44 45 49 Troup 46 48 54 51 Harris Upson Bibb Wilkinson Talbot Crawford Twiggs Jenkins Johnson Emanuel Screven 43 57 53 Muscogee 67 60 55 Marion 63 Chattahoochee Taylor Peach Houston Macon Bleckley Laurens Treutlen Candler Montgomery Bulloch Effingham 66 59 58 56 Stewart Schley Pulaski Dodge Dooly Wheeler Toombs Evans Bryan Chatham 69 68 65 64 62 61 52 Quitman Webster Sumter Terrell Lee Wilcox Crisp Ben Hill Telfair Jeff Davis Tattnall Appling Liberty Long 70 87 89 91 92 Randolph Turner 79 86 90 Clay Calhoun Dougherty Worth 71 76 77 85 88 94 93 Early Baker Irwin Tift Berrien 78 80 Miller Mitchell Colquitt Cook Coffee Atkinson Bacon Wayne PPieIErRcCeE Ware Brantley McIntosh Glynn 72 84 83 Seminole 95 96 Decatur Grady Thomas Lanier Clinch Brooks Lowndes Charlton Camden 73 74 75 81 82Echols * A PCSA (Primary Care Service Area) is categorized as deficit, adequate, or surplus based on the +/-1 standard deviation of the physician rate per 100,000 in 2006. In 2006, there are fewer areas of physician deficit. The top three areas of surplus are: Area 4: Fannin Area 80: Cook Area 70: Quitman, Randolph The bottom three areas of deficit are: Area 36: Jasper, Newton Area 86: Irwin Area 37: Pike, Spalding The adequate range for family medicine physicians in PCSAs in 2006 (based on +/- 1.0 standard deviation) is 14.2 to 38.8. In 2006, there was a slight decrease in the rate of family practice physicians per 100,000 population, but an increase in number. Areas of surplus are fairly consistent between 2004 and 2006. Most PCSAs have an adequate supply of family practice physicians, but geographic distribution continues to be a problem. Family Practice Physicians (by Gender) 100% 81.3 80% 79.4 79.0 77.4 77.7 71.0 60% 40% 18.7 20.6 21.0 22.6 22.3 29.0 20% 0% 1996 1998 2000 Male 2002 2004 Female 2006 9 Family Practice Physicians by Gender, MSA/Non-MSA and Year (percent) Gender MSA Male Female Non-MSA Male Female 2004 75.0 25.0 84.4 15.6 2006 68.2 31.8 79.8 20.2 INTERNAL MEDICINE PROFILE - 2006 TOP 10 PRIMARY CARE SERVICE AREAS (PCSAs) BY NUMBER OF INTERNAL MEDICINE PHYSICIANS RANK* 1. Area 31: Columbia, Lincoln, Richmond (144)** 2. Area 52: Bryan, Chatham, Effingham, Liberty (95) 3. Area 46: Bibb, Crawford, Jones, Peach, Taylor, Twiggs, Wilkinson (84) 4. Area 76: Baker, Calhoun, Clay, Dougherty, Lee, Mitchell, Terrell (49) 5. Area 22: Fulton (46) 6. Area 39: Clayton (46) 7. Area 11: Dawson, Hall, White (46) 8. Area 43: Chattahoochee, Harris, Marion, Muscogee, Talbot (41) 9. Area 40: Fayette (38) 10. Area 67: Houston (34) * Numbers correspond to rank. ** Numbers in parenthesis respresent the number of physicians. 7 2 56 9 3 8 10 4 1 2 PIERCE Internal Medicine Physician Supply Number 3,000 2,500 2,000 2,652 2,506 2,471 2,264 1,971 1,718 1,500 1,000 500 0 1996 2000 2004 1998 2002 2006 10 Between 1996 and 2006, the number of internal medicine physicians in Georgia increased 43.8%. In 2006, there were five PCSAs that had no internal medicine physicians in their region. This includes the following counties: Early, Hancock, Quitman, Randolph, Stewart, Webster, and Wheeler. The first time the physician workforce saw a decrease in number and rate from the previous renewal cycle was in 2006. The top three PCSAs for number of practicing internal medicine physicians are in Metropolitan Statistical Areas. Internal Medicine Internal Medicine Physician Distribution - 2006 Deficit, Adequate, and Surplus PCSAs* Dade CatoosaWhitfield Fannin Towns Rabun Union 1 2 3 4 5 6 7 Walker 16 14 12 11 10 8 Deficit Chattooga 18 17 15 13 9 28 ASudrepqluuaste Floyd Murray Gilmer Gordon Pickens White Habersham Lumpkin Stephens Dawson Hall Banks Franklin Hart Bartow Cherokee Forsyth Jackson Elbert Madison 27 29 Polk 21 Paulding Cobb 25 Haralson Gwinnett Dekalb Barrow Walton Clarke Oconee Oglethrope Wilkes Lincoln 23 26 30 Douglas Fulton Rockdale 19 20 22 24 31 Carroll Clayton Newton Morgan Greene Taliaferro Columbia McDuffie 39 38 36 34 32 Coweta Fayette Henry Jasper 41 40 Heard Spalding Butts Warren Putnam Hancock Glascock Richmond 42 37 3547 33 50 Meriwether Pike Lamar Monroe 49 Troup Baldwin Jones Jefferson Washington Burke 44 45 46 48 54 51 Harris Upson Bibb Wilkinson Talbot Crawford Twiggs Johnson Jenkins Emanuel Screven 43 67 57 55 53 Muscogee 63 60 Marion Chattahoochee Taylor Peach Houston Macon Laurens Bleckley Treutlen Candler Montgomery Bulloch Effingham 66 59 58 56 Schley Stewart 68 64 62 52 Webster Sumter 69 65 61 Quitman Terrell Lee Pulaski Dodge Dooly Wilcox Crisp Ben Hill Wheeler Evans Toombs Tatnall Bryan Telfair Jeff Davis Appling Liberty Long Chatham 70 87 89 91 92 Randolph Turner 76 Clay Calhoun Dougherty Early 71 Baker Miller 72 Seminole Mitchell 79 86 88 Worth Irwin Tift Coffee 77 85 Berrien Atkinson 78 80 83 Colquitt Cook 84 Lanier Clinch Decatur Grady Thomas Brooks Ba9co0n Wayne McIntosh PPIiEeRrCcEe 94 Ware 93 Brantley Glynn Charlton 95 Camden 96 73 74 75 81 82 Lowndes Echols * A PCSA (Primary Care Service Area) is categorized as deficit, adequate, or surplus based on the +/-1 standard deviation of the physician rate per 100,000 in 2006. Between 2004 and 2006 there are the same number of PCSAs in deficit. Some areas improved from deficit to adequate, while some went from adequate to deficit. The top three areas of surplus are: Area 73: Decatur Area 22: Fulton Area 31: Columbia, Lincoln, Richmond The bottom three areas of deficit are: Area 33: Hancock Area 59: Wheeler Area 69: Stewart, Webster The adequate range for internal medicine physicians in PCSAs in 2006 (based on +/- 1.0 standard deviation) is 16.1 to 37.2. In 2006, there are fewer areas of surplus. This a result of the decrease in the number and rate of internal medicine physicians. Internal Medicine Physicians (by Gender) 100% Internal Medicine Physicians by Gender, MSA/Non-MSA and Year (percent) 78.6 76.9 76.5 78.7 80% 60% 78.1 69.2 GENDER MSA Male 2004 76.9 2006 67.3 Female 23.1 32.7 40% 30.8 Non-MSA Male 82.8 80.3 21.4 23.1 23.5 21.3 21.9 20% Female 17.2 19.7 0% 1996 1998 2000 Male 2002 2004 Female 2006 11 PEDIATRICS PROFILE - 2006 TOP 10 PRIMARY CARE SERVICE AREAS (PCSAs) BY NUMBER OF PEDIATRICIANS RANK* 1. Area 22: Fulton (291)** 2. Area 23: Dekalb (213) 3. Area 25: Gwinnett (128) 4. Area 21: Cobb, Paulding (125) 5. Area 31: Columbia, Lincoln, Richmond (100) 6. Area 52: Bryan, Chatham, Effingham, Liberty (72) 7. Area 27: Barrow, Clarke, Jackson, Madison, Morgan, Oconee, Oglethorpe (39) 8. Area 39: Clayton (36) 9. Area 46: Bibb, Crawford, Jones, Peach, Taylor, Twiggs, Wilkinson (35) 10. Area 43: Chattahoochee, Harris, Marion, Muscogee, Talbot (31) * Numbers correspond to rank. ** Numbers in parenthesis respresent the number of physicians. 4 3 7 2 18 9 10 5 6 PIERCE Number Pediatrician Physician Supply 2,000 1,500 1,402 1,495 1,588 1,548 1,280 964 1,000 500 0 1996 2000 2004 1998 2002 2006 12 Between 1996 and 2006, the number of pediatricians in Georgia increased 60.6%. In 2006, there were 19 PCSAs that had no pediatrician in their region (this is approximately 20% of the state's PCSAs and 3% of Georgia's population). The first decrease in the number and rate of pediatricians in Georgia from the previous cycle occurred in 2006. The top three PCSAs for number of practicing pediatricians are in the Atlanta Metropolitan Statistical Area. Pediatrics Pediatrics Physician Distribution - 2006 Deficit, Adequate, and Surplus PCSAs* 4 6 Dade Catoosa Whitfield Fannin Towns Rabun Union 1 2 3 5 7 8 Deficit Walker 12 Adequate Chattooga Murray Gordon 18 1167 1154 13 11 10 9 28 Surplus Floyd Bartow Gilmer Pickens White Habersham Lumpkin Stephens Dawson Banks Franklin Hart Cherokee Forsyth Hall Jackson Elbert Madison 27 29 Polk 21Cobb Paulding 25 Haralson Gwinnett Dekalb Barrow Walton Clarke Oglethorpe Oconee Wilkes Lincoln 19 20 22 23 24 26 30 31 Carroll Douglas Fulton Rockdale Clayton Newton Morgan GreeneTaliaferro Columbia McDuffie 41 40339738 36 35 34 33 32 Heard Coweta Fayette Henry Spalding Butts Jasper Warren Putnam Hancock Glascock Richmond Baldwin Jefferson Burke 42 50 Meriwether Pike Lamar Monroe 44 45 47 49 Troup Jones Washington 48 Upson Bibb Wilkinson Jenkins 46 54 51 Harris Talbot Crawford Twiggs Johnson Emanuel Screven 43 67 57 55 53 Muscogee Taylor 63 60 Marion Chattahoochee Macon 66 59 56 Schley 68 64 62 58 52 Stewart 69 Webster Sumter Peach Houston Laurens Bleckley Treutlen Candler Bulloch Effingham Dooly Pulaski Wilcox Dodge Montgomery Wheeler Telfair Evans Tattnall Toombs Bryan Liberty Chatham 65 61 Quitman Terrell Lee Crisp Ben Hill Jeff Davis Appling Long 70 87 89 91 92 Randolph Turner 76 Clay Calhoun Dougherty Early 71 Baker Miller 72 Seminole Mitchell 79 Worth Irwin 86 77 Tift 85 Coffee 88 78 Colquitt Berrien 80 Atkinson Cook 84 Lanier 83 Clinch Decatur 73 Grady 74 Thomas Brooks 75 81 82 Lowndes Echols Ba9co0n Wayne McIntosh 94 PPieIErRcCeE 93 Glynn Brantley Ware Charlton 95 Camden 96 In 2006, there were 48 (50%) of the PCSAs in deficit. This improved slightly from 2004, which saw 50 areas in deficit (52%). The top three areas of surplus: Area 73: Decatur Area 31: Columbia, Lincoln, Richmond Area 22: Fulton The bottom three areas of deficit are: Area 6: Towns Area 28: Hart Area 29: Elbert The adequate range for pediatric physicians in PCSAs in 2006 (based on +/- 1.0 standard deviation) is 9.9 to 23.9. * A PCSA (Primary Care Service Area) is categorized as deficit, adequate, or surplus based on the +/-1 standard deviation of the physician rate per 100,000 in 2006. Pediatrics also experienced a slight rise in surplus areas. Pediatricians (by Gender) 100% 80% 57.7 60% 57.9 55.4 56.6 59.7 53.8 42.3 42.1 44.6 43.4 46.2 40.3 40% 20% Pediatricians by Gender, MSA/Non-MSA and Year (percent) GENDER MSA Male Female Non-MSA Male Female 2004 59.7 40.3 59.5 40.5 2006 45.6 54.4 51.1 48.9 0% 1996 1998 2000 2002 Male Female 2004 2006 13 OB/GYN PROFILE - 2006 TOP 10 PRIMARY CARE SERVICE AREAS (PCSAs) BY NUMBER OF OB/GYN PHYSICIANS RANK* 1. Area 22: Fulton (247)** 2. Area 21: Cobb, Paulding (76) 3. Area 23: Dekalb (68) 4. Area 31: Columbia, Lincoln, Richmond (67) 5. Area 25: Gwinnett (51) 6. Area 52: Bryan, Chatham, Effingham, Liberty (46) 7. Area 46: Bibb, Crawford, Jones, Peach, Taylor, Twiggs, Wilkinson (40) 8. Area 27: Barrow, Clarke, Jackson, Madison, Morgan, Oconee, Oglethorpe (28) 9. Area 76: Baker, Calhoun, Clay, Dougherty, Lee, Mitchell, Terrell (23) 10. Area 43: Chattahoochee, Harris, Marion, Muscogee, Talbot (23) * Numbers correspond to county code. ** Numbers in parenthesis respresent the number of physicians. 2 5 8 3 1 7 10 9 4 6 PIERCE OB/GYN Physician Supply 1,500 1,138 1,171 986 1,000 891 903 1,027 Number 500 0 1996 2000 2004 1998 2002 2006 14 Between 1996 and 2006, the number of OB/GYN physicians in Georgia increased by 15.3%. This is only a modest increase when Georgia's population increased 26.4% between 1996 and 2006. In 2006, there were 24 PCSAs that had no OB/GYN in their region (this is approximately 25% of the state's PCSAs and 4% of the state's population). The top three PCSAs for number of practicing OB/GYN physicians are in the Atlanta Metropolitan Statistical Area. The number and rate of OB/GYN physicians decreased between 2004 and 2006. OB/GYN Physician Distribution - 2006 Deficit, Adequate, and Surplus PCSAs* OB/GYN 4 6 Dade Catoosa Whitfield Fannin Towns Union Rabun 1 2 3 5 7 Deficit Walker 8 Adequate Chattooga 18 1167 1154 13 12 11 10 9 28 Surplus Floyd Murray Gordon Bartow Gilmer White Habersham Lumpkin Stephens Pickens Dawson Cherokee Forsyth Banks Franklin Hart Hall Jackson Elbert Madison 27 29 Polk 21 Paulding Cobb 25 Haralson Gwinnett Dekalb Barrow Walton Clarke Oglethorpe Oconee Wilkes Lincoln 19 20 22 23 24 26 30 31 Carroll Douglas Fulton Rockdale Clayton Newton Morgan Greene Taliaferro Columbia McDuffie 41 4039 38 36 35 34 32 Heard Coweta Fayette Henry Spalding Butts Jasper Warren Putnam Hancock Glascock Richmond 37 33 Baldwin Jefferson Burke 42 50 Meriwether Pike Lamar Monroe 47 49 Troup Jones Washington 44 45 46 48 54 51 Harris Upson Bibb Wilkinson Talbot Crawford Twiggs Johnson Jenkins Emanuel Screven 6943 68 66 6567 6463 62 6059 5857 5556 53 52 CMhuaSstttecaowhgoaeorteWchMeeabersiotenrSchlTeSayuymloMrtearconPDeoHaocolyhustoPnWulailBcsokleixckleDyodgeLauTreeWlnfashireeleTMrJreeoufnfttlegTnoomoemrybsCaTnadttlnearEllvaBnsullochLibBerEyrtafyfninghaCmhatham 61 Quitman Terrell Lee Crisp Ben Hill Davis Appling Long 70 87 89 91 92 Randolph Turner 76 Clay Calhoun Dougherty Early 71 Baker Miller 72 Seminole Mitchell 79 86 88 Worth Irwin Tift Coffee 77 85 Berrien Atkinson 78 80 84 83 Colquitt Cook Lanier Clinch Decatur 73 Grady 74 Thomas Brooks 75 81 Lowndes 82Echols Bacon 90 Wayne McIntosh 94 93 PPieIErRcCeE Brantley Glynn Ware Charlton 95 Camden 96 * A PCSA (Primary Care Service Area) is categorized as deficit, adequate, or surplus based on the +/-1 standard deviation of the physician rate per 100,000 in 2006. In 2006, there are 42 PCSAs in deficit (44%). This is an increase from 2004 where 37 areas (39%) of PCSAs were in deficit. The top three areas of surplus are: Area 22: Fulton Area 31: Columbia, Lincoln, Richmond Area 72: Miller The bottom three areas of deficit are: Area 3: Gilmer Area 5: Union Area 6: Towns The adequate range for OB/GYN physicians in PCSAs in 2006 (based on +/- 1.0 standard deviation) is 6.9 to 16.0. OB/GYN also saw a slight increase in areas of surplus in 2006. OB/GYN Physicians (by Gender) 100% 80% 75.5 72.7 70.5 71.1 69.7 60.3 60% 39.7 40% 27.3 29.5 28.9 30.3 24.5 20% 0% 1996 1998 2000 Male 2002 2004 Female 2006 OB/GYN Physicians by Gender, MSA/Non-MSA and Year (percent) GENDER MSA Male Female Non-MSA Male Female 2004 68.5 31.5 74.6 25.4 2006 58.6 41.4 71.8 28.2 15 GENERAL SURGERY PROFILE - 2006 TOP 10 PRIMARY CARE SERVICE AREAS (PCSAs) BY NUMBER OF GENERAL SURGEONS RANK* 1. Area 22: Fulton (115)** 2. Area 23: Dekalb (60) 3. Area 31: Columbia, Lincoln, Richmond (56) 4. Area 52: Bryan, Chatham, Effingham, Liberty (43) 5. Area 21: Cobb, Paulding (43) 6. Area 46: Bibb, Crawford, Jones, Peach, Taylor, Twiggs, Wilkinson (32) 7. Area 25: Gwinnett (24) 8. Area 11: Dawson, Hall, White (23) 9. Area 43: Chattahoochee, Harris, Marion, Muscogee, Talbot, (20) 10. Area 39: Clayton (14) * Numbers correspond to rank. ** Numbers in parenthesis respresent the number of physicians. 8 5 7 2 1 10 6 9 3 4 PIERCE General Surgery Physician Supply 1,000 691 708 771 726 733 699 500 Between 1996 and 2006, the number of general surgery physicians, in Georgia increased by 1.2%. This is the smallest increase of the core specialties examined in this document. In 2006, there were 20 PCSAs with no general surgery physician in their region (this is approximately 21% of the state's PCSAs and 3% of the state's population). Number 0 1996 2000 2004 1998 2002 2006 16 The top five PCSAs for number of practicing general surgery physicians are in Metropolitan Statistical Areas. The number and rate of general surgery physicians decreased between 2004 and 2006. General Surgery General Surgery Physician Distribution - 2006 Deficit, Adequate, and Surplus PCSAs* 4 6 Dade Catoosa Whitfield Fannin Towns Union Rabun 1 2 3 5 7 Deficit Walker 8 Adequate Chattooga 18 1167 1145 1312 11 10 9 28 Surplus Floyd Murray Gordon Bartow Gilmer White Habersham Pickens Lumpkin Dawson Stephens Banks Franklin Hart Cherokee Forsyth Hall Jackson Elbert Madison 27 29 Polk 21Cobb Paulding 25 Haralson Gwinnett Dekalb Barrow Clarke Oglethorpe Walton Oconee Wilkes Lincoln 19 20 22 23 24 26 34 30 31 Carroll Douglas Fulton Clayton Rockdale Newton Morgan Greene Taliaferro Columbia McDuffie 41 4039 38 36 35 32 Heard Coweta Fayette Henry Jasper Spalding Butts Putnam Warren Hancock Glascock Richmond 42 37 33 50 Meriwether Pike Lamar Monroe 47 49 Troup Baldwin Jones Jefferson Washington Burke 44 45 46 48 54 51 Harris Upson Talbot Crawford Bibb Wilkinson Twiggs Johnson Jenkins Emanuel Screven 43 67 57 55 53 Muscogee 60 Marion Taylor Peach Houston Bleckley Laurens Treutlen Candler Bulloch Effingham 63 Chattahoochee Macon 66 59 56 Schley 69 68 65 64 62 58 52 Stewart Webster Sumter Dooly Pulaski Wilcox Dodge Montgomery Wheeler Telfair Jeff Toombs Evans Tattnall Bryan Chatham Liberty 61 Quitman Terrell Lee Crisp Ben Hill Davis Appling Long 70 87 89 91 92 Randolph Turner 79 86 90 Clay Calhoun Dougherty Worth 76 77 85 88 94 93 Early Baker Irwin Tift Berrien 71 78 80 Miller Mitchell Colquitt Cook Coffee Bacon Wayne Atkinson PPieIErRcCeE Ware Brantley McIntosh Glynn 72 84 83 Seminole Lanier Clinch Charlton Camden 73 74 75 81 82 95 96 Decatur Grady Thomas Brooks Lowndes Echols * A PCSA (Primary Care Service Area) is categorized as deficit, adequate, or surplus based on the +/-1 standard deviation of the physician rate per 100,000 in 2006. In 2006, there are 27 PCSAs in deficit (28%). The top three areas of surplus are: Area 65: Crisp Area 31: Columbia, Lincoln, Richmond Area 75: Thomas The bottom three areas of deficit are: Area 6: Towns Area 30: Taliaferro, Wilkes Area 33: Hancock The adequate range for general surgery physicians in PCSAs in 2006 (based on +/1.0 standard deviation) is 4.0 to 11.4 General Surgery also saw a slight increase in areas of surplus in 2006 (14 in 2006 and 12 in 2004). General Surgery Physicians (by Gender) 100% 95.6 94.2 92.2 80% 93.7 93.3 91.4 60% 40% General Surgery Physicians by Gender, MSA/Non-MSA and Year (percent) GENDER MSA Male Female Non-MSA Male 2004 92.0 8.0 98.0 2006 89.8 10.2 99.1 Female 2.0 0.9 20% 4.4 5.8 7.8 6.3 6.7 8.6 0% 1996 1998 2000 2002 Male Female 2004 2006 17 GEOGRAPHIC DISTRIBUTION Primary Care PHYSICIANS BY SPECIALTY BY COUNTY, GEORGIA, 2006 Number, Rate and Rank NUMBER OF PHYSICIANS BY SPECIALTY 1 County Population PRIMARY CARE (Generalists) OB/GYN TOTAL General Surgery ALL SPEC. Family Practice Internal Medicine Pediatrics 2006 # Rate2 Rank3 # Rate Rank # Rate Rank # Rate Rank # Rate Rank # Appling Atkinson Bacon Baker Baldwin Banks Barrow Bartow Ben Hill Berrien Bibb Bleckley Brantley Brooks Bryan Bulloch Burke Butts Calhoun Camden Candler Carroll Catoosa Charlton Chatham Chattahoochee Chattooga Cherokee Clarke Clay Clayton Clinch Cobb 17,737 4 22.6 7,970 1 12.5 10,294 5 48.6 3,998 1 25.0 45,576 19 41.7 15,955 1 6.3 59,437 14 21.9 88,277 27 30.6 17,221 8 46.5 16,638 6 36.1 154,492 67 43.4 11,984 4 33.4 15,286 2 13.1 16,127 4 24.8 27,827 4 14.4 63,587 13 20.4 22,872 8 35.0 22,483 3 13.3 6,048 5 82.7 46,049 7 15.2 10,096 5 49.5 104,567 22 21.0 59,756 18 30.1 10,595 5 47.2 240,261 80 33.3 11,969 11 91.9 25,939 7 27.0 183,123 43 23.5 109,341 30 27.4 3,164 0 0 265,503 41 15.4 7,052 1 14.2 663,714 117 17.6 92 8 45.1 9 2 11.3 123 1 12.5 83 0 0 19 4 38.9 12 1 9.7 80 0 0 108 0 0 28 18 39.5 10 8 17.6 135 2 12.5 83 0 0 95 6 10.1 89 6 10.1 56 17 19.3 54 5 5.7 22 3 17.4 63 1 5.8 40 1 6.0 100 0 0 24 79 51.1 5 35 22.7 47 3 25.0 36 1 8.3 121 0 0 108 1 6.5 82 1 6.2 98 1 6.2 118 6 21.6 46 2 7.2 101 11 17.3 64 8 12.6 45 3 13.1 81 1 4.4 120 2 8.9 93 2 8.9 3 1 16.5 68 0 0 114 13 28.2 28 7 15.2 17 1 9.9 91 0 0 99 18 17.2 65 19 18.2 58 11 18.4 59 9 15.1 20 3 28.3 27 1 9.4 48 76 31.6 20 58 24.1 2 1 8.4 95 0 0 72 1 3.9 103 0 0 89 25 13.7 78 20 10.9 70 37 33.8 18 22 20.1 136 1 31.6 20 0 0 113 46 17.3 64 36 13.6 119 2 28.4 26 1 14.2 109 150 22.6 40 123 18.5 47 3 16.9 15 2 11.3 82 0 0 80 0 0 57 1 9.7 40 1 9.7 82 0 0 80 0 0 26 6 13.2 27 7 15.4 82 0 0 80 0 0 54 3 5.0 65 1 1.7 77 5 5.7 62 6 6.8 76 1 5.8 61 1 5.8 82 0 0 80 0 0 11 40 25.9 3 32 20.7 64 1 8.3 49 1 8.3 74 0 0 80 0 0 75 0 0 80 0 0 71 2 7.2 54 0 0 43 9 14.2 23 4 6.3 79 1 4.4 68 0 0 61 0 0 80 0 0 82 1 16.5 18 1 16.5 31 3 6.5 57 4 8.7 82 0 0 80 0 0 22 10 9.6 41 6 5.7 32 7 11.7 31 7 11.7 58 1 9.4 43 1 9.4 9 39 16.2 20 38 15.8 82 2 16.7 17 1 8.4 82 1 3.9 71 0 0 49 17 9.3 44 3 1.6 16 24 21.9 6 11 10.1 82 0 0 80 0 0 38 23 8.7 47 14 5.3 35 0 0 80 0 0 20 75 11.3 32 42 6.3 21 32 72 3 28 15 72 1 8 125 72 5 68 51 45 116 52 21 72 11 3 588 36 13 72 3 72 6 72 16 49 89 72 20 72 10 6 12 34 73 72 7 53 176 20 135 29 16 7 727 35 22 72 12 69 184 25 355 72 2 55 358 72 6 49 1,138 18 GEOGRAPHIC DISTRIBUTION Primary Care PHYSICIANS BY SPECIALTY BY COUNTY, GEORGIA, 2006 Number, Rate and Rank NUMBER OF PHYSICIANS BY SPECIALTY 1 County Coffee Colquitt Columbia Cook Coweta Crawford Crisp Dade Dawson Decatur DeKalb Dodge Dooly Dougherty Douglas Early Echols Effingham Elbert Emanuel Evans Fannin Fayette Floyd Forsyth Franklin Fulton Gilmer Glascock Glynn Gordon Grady Greene Population PRIMARY CARE (Generalists) OB/GYN TOTAL General Surgery ALL SPEC. Family Practice Internal Medicine Pediatrics 2006 # Rate2 Rank3 # Rate Rank # Rate Rank # Rate Rank # Rate Rank # 39,184 43,459 102,350 16,291 108,921 12,623 21,775 15,892 19,686 27,984 719,412 19,613 11,648 95,211 112,465 12,014 4,102 46,371 20,654 22,047 11,271 21,777 102,662 94,262 138,719 21,495 934,242 27,240 2,616 71,480 49,645 24,287 15,451 12 30.6 15 34.5 28 27.4 10 61.4 17 15.6 3 23.8 6 27.6 7 44.0 7 35.6 12 42.9 153 21.3 7 35.7 3 25.8 36 37.8 17 15.1 6 49.9 1 24.4 13 28.0 8 38.7 7 31.8 4 35.5 16 73.5 27 26.3 62 65.8 40 28.8 10 46.5 233 24.9 10 36.7 4 152.9 20 28.0 19 38.3 8 32.9 6 38.8 56 8 20.4 49 6 15.3 46 7 16.1 71 3 6.9 70 18 17.6 61 8 7.8 10 1 6.1 99 0 0 112 18 16.5 68 8 7.3 88 0 0 108 0 0 69 6 27.6 30 4 18.4 23 4 25.2 35 3 18.9 43 1 5.1 102 2 10.2 25 21 75.0 1 12 42.9 97 279 38.8 13 213 29.6 42 7 35.7 17 5 25.5 75 3 25.8 34 1 8.6 36 43 45.2 8 20 21.0 115 20 17.8 60 17 15.1 16 0 0 108 0 0 85 0 0 108 0 0 68 6 12.9 82 0 0 32 5 24.2 37 0 0 52 3 13.6 79 0 0 44 1 8.9 93 1 8.9 5 3 13.8 77 4 18.4 74 38 37.0 16 23 22.4 8 37 39.3 11 14 14.9 63 23 16.6 67 24 17.3 22 5 23.3 39 2 9.3 81 544 58.2 3 291 31.1 39 5 18.4 59 2 7.3 1 1 38.2 14 0 0 68 15 21.0 47 11 15.4 35 11 22.2 43 6 12.1 49 4 16.5 68 0 0 31 3 19.4 53 2 12.9 30 4 10.2 72 3 6.9 67 2 2.0 82 1 6.1 70 6 5.5 82 0 0 21 3 13.8 19 0 0 53 0 0 2 5 17.9 5 68 9.5 8 2 10.2 62 1 8.6 15 21 22.1 32 9 8.0 82 0 0 82 0 0 82 1 2.2 82 0 0 82 1 4.5 61 1 8.9 21 2 9.2 13 10 9.7 33 12 12.7 27 2 1.4 59 2 9.3 4 247 26.4 70 0 0 82 0 0 29 12 16.8 45 3 6.0 82 3 12.4 40 1 6.5 36 4 10.2 56 3 6.9 75 1 1.0 59 0 0 63 7 6.4 80 0 0 25 4 18.4 80 1 6.3 80 0 0 12 4 14.3 43 60 8.3 36 1 5.1 48 0 0 4 13 13.7 51 5 4.4 80 0 0 80 0 0 74 2 4.3 80 1 4.8 67 2 9.1 46 1 8.9 45 2 9.2 40 10 9.7 28 7 7.4 78 5 3.6 44 1 4.7 2 115 12.3 80 2 7.3 80 0 0 16 9 12.6 60 2 4.0 29 2 8.2 57 1 6.5 24 68 44 59 70 119 72 13 48 107 72 3 5 33 49 18 72 13 10 113 36 2,234 56 34 72 10 11 291 60 124 72 6 72 1 61 31 58 19 31 22 32 12 30 38 28 183 41 307 64 159 59 26 17 3,894 42 26 72 5 15 198 63 59 37 19 47 17 19 GEOGRAPHIC DISTRIBUTION Primary Care PHYSICIANS BY SPECIALTY BY COUNTY, GEORGIA, 2006 Number, Rate and Rank NUMBER OF PHYSICIANS BY SPECIALTY 1 County Gwinnett Habersham Hall Hancock Haralson Harris Hart Heard Henry Houston Irwin Jackson Jasper Jeff Davis Jefferson Jenkins Johnson Jones Lamar Lanier Laurens Lee Liberty Lincoln Long Lowndes Lumpkin Macon Madison Marion McDuffie McIntosh Meriwether Population PRIMARY CARE (Generalists) OB/GYN TOTAL General Surgery ALL SPEC. Family Practice Internal Medicine Pediatrics 2006 # Rate2 Rank3 # Rate Rank # Rate Rank # Rate Rank # Rate Rank # 720,076 136 18.9 104 138 19.2 55 128 17.8 24 51 7.1 55 24 3.3 65 913 39,396 8 20.3 102 11 27.9 29 5 12.7 42 2 5.1 64 4 10.2 24 42 165,621 38 22.9 91 45 27.2 31 23 13.9 37 21 12.7 28 22 13.3 13 346 9,454 5 52.9 13 0 0 108 0 0 82 0 0 80 0 0 72 5 28,144 9 32.0 51 4 14.2 75 0 0 82 0 0 80 1 3.6 64 19 27,368 2 7.3 133 2 7.3 97 0 0 82 0 0 80 0 0 72 7 23,881 9 37.7 37 4 16.7 66 0 0 82 0 0 80 3 12.6 15 20 11,246 1 8.9 132 0 0 108 0 0 82 0 0 80 0 0 72 1 167,171 39 23.3 90 19 11.4 86 22 13.2 39 17 10.2 36 6 3.6 64 193 125,975 26 20.6 100 34 27.0 33 13 10.3 52 13 10.3 35 7 5.6 54 179 10,126 1 9.9 129 1 9.9 91 1 9.9 56 1 9.9 39 0 0 72 4 52,010 11 21.1 98 3 5.8 101 4 7.7 68 1 1.9 76 0 0 72 23 13,023 2 15.4 113 4 30.7 22 0 0 82 0 0 80 1 7.7 40 10 13,039 4 30.7 55 4 30.7 22 0 0 82 0 0 80 2 15.3 9 11 16,648 6 36.0 41 4 24.0 38 2 12.0 46 0 0 80 1 6.0 51 18 8,587 2 23.3 90 1 11.6 85 0 0 82 0 0 80 0 0 72 3 8,905 2 22.5 93 2 22.5 41 0 0 82 0 0 80 0 0 72 5 26,684 4 15.0 116 0 0 108 0 0 82 0 0 80 0 0 72 7 16,604 4 24.1 86 1 6.0 100 0 0 82 2 12.0 30 0 0 72 11 7,416 2 27.0 72 2 27.0 33 0 0 82 0 0 80 0 0 72 6 46,680 20 42.8 26 22 47.1 7 6 12.9 40 9 19.3 8 6 12.9 14 122 30,867 3 9.7 131 1 3.2 106 1 3.2 80 0 0 80 0 0 72 10 63,021 10 15.9 111 7 11.1 87 12 19.0 18 4 6.3 58 3 4.8 58 64 8,179 2 24.5 84 0 0 108 0 0 82 0 0 80 0 0 72 2 10,905 0 0 136 0 0 108 0 0 82 0 0 80 0 0 72 0 98,594 26 26.4 73 22 22.3 42 8 8.1 66 10 10.1 37 12 12.2 18 185 24,833 8 32.2 50 3 12.1 84 2 8.1 66 2 8.1 50 2 8.1 38 26 13,554 5 36.9 38 2 14.8 73 0 0 82 1 7.4 52 1 7.4 41 15 27,245 5 18.4 106 1 3.7 104 3 11.0 48 0 0 80 0 0 72 9 7,016 5 71.3 6 0 0 108 0 0 82 0 0 80 0 0 72 5 21,416 6 28.0 68 4 18.7 56 2 9.3 59 0 0 80 1 4.7 59 22 10,928 2 18.3 107 0 0 108 1 9.2 60 0 0 80 0 0 72 3 22,838 6 26.3 74 4 17.5 62 0 0 82 1 4.4 68 1 4.4 60 19 20 GEOGRAPHIC DISTRIBUTION Primary Care PHYSICIANS BY SPECIALTY BY COUNTY, GEORGIA, 2006 Number, Rate and Rank NUMBER OF PHYSICIANS BY SPECIALTY 1 County Miller Mitchell Monroe Montgomery Morgan Murray Muscogee Newton Oconee Oglethorpe Paulding Peach Pickens Pierce Pike Polk Pulaski Putnam Quitman Rabun Randolph Richmond Rockdale Schley Screven Seminole Spalding Stephens Stewart Sumter Talbot Taliaferro Tattnall Population PRIMARY CARE (Generalists) OB/GYN TOTAL General Surgery ALL SPEC. Family Practice Internal Medicine Pediatrics 2006 # Rate2 Rank3 # Rate Rank # Rate Rank # Rate Rank # Rate Rank # 6,100 5 82.0 23,497 7 29.8 23,599 6 25.4 8,876 1 11.3 17,296 2 11.6 40,191 5 12.4 188,672 112 59.4 85,813 6 7.0 29,308 8 27.3 13,444 4 29.8 111,191 12 10.8 24,543 7 28.5 28,178 7 24.8 17,173 5 29.1 15,974 2 12.5 40,303 19 47.1 9,659 5 51.8 19,666 5 25.4 2,599 1 38.5 16,151 5 31.0 7,343 5 68.1 196,944 97 49.3 78,000 22 28.2 3,948 0 0 15,189 3 19.8 9,098 2 22.0 61,126 6 9.8 25,076 6 23.9 4,803 2 41.6 32,408 7 21.6 6,593 0 0 1,857 0 0 22,890 15 65.5 4 1 16.4 69 59 2 8.5 94 76 2 8.5 94 127 2 22.5 41 125 3 17.3 64 124 4 10.0 90 11 38 20.1 50 134 19 22.1 44 71 6 20.5 48 59 0 0 108 128 4 3.6 105 65 4 16.3 70 82 8 28.4 26 61 0 0 108 123 0 0 108 21 3 7.4 96 14 3 31.1 21 76 3 15.3 72 33 0 0 108 54 3 18.6 57 7 0 0 108 18 126 64.0 2 67 29 37.2 15 136 0 0 108 103 2 13.2 80 94 2 22.0 45 130 18 29.4 24 87 5 19.9 51 29 0 0 108 96 7 21.6 46 136 0 0 108 136 0 0 108 9 3 13.1 81 1 16.4 2 8.5 00 00 00 3 7.5 31 16.4 7 8.2 4 13.6 00 2 1.8 00 3 10.6 00 00 00 1 10.4 2 10.2 00 1 6.2 00 92 46.7 14 17.9 00 00 2 22.0 5 8.2 6 23.9 00 4 12.3 00 00 00 28 1 16.4 19 0 0 63 1 4.3 69 0 0 82 0 0 80 0 0 82 0 0 80 0 0 82 0 0 80 1 5.8 69 1 2.5 73 1 2.5 28 21 11.1 33 19 10.1 65 4 4.7 66 2 2.3 38 0 0 80 0 0 82 0 0 80 0 0 81 1 0.9 79 1 0.9 82 0 0 80 0 0 50 3 10.6 34 3 10.6 82 0 0 80 0 0 82 0 0 80 0 0 82 0 0 80 1 2.5 51 2 20.7 7 0 0 53 1 5.1 64 0 0 82 0 0 80 0 0 75 0 0 80 2 12.4 82 0 0 80 1 13.6 1 65 33.0 1 55 27.9 23 11 14.1 24 6 7.7 82 0 0 80 0 0 82 0 0 80 0 0 14 2 22.0 5 2 22.0 65 10 16.4 19 6 9.8 10 4 16.0 22 3 12.0 82 0 0 80 0 0 44 6 18.5 11 2 6.2 82 0 0 80 0 0 82 0 0 80 0 0 82 0 0 80 0 0 72 9 72 16 72 11 72 3 52 11 66 17 25 497 67 77 72 29 72 5 71 29 72 15 23 30 72 6 72 2 66 30 72 19 72 15 72 1 16 18 12 6 1 1,289 40 148 72 0 72 5 2 11 27 84 19 41 72 3 50 48 72 0 72 0 72 25 21 GEOGRAPHIC DISTRIBUTION Primary Care PHYSICIANS BY SPECIALTY BY COUNTY, GEORGIA, 2006 Number, Rate and Rank NUMBER OF PHYSICIANS BY SPECIALTY 1 County Taylor Telfair Terrell Thomas Tift Toombs Towns Treutlen Troup Turner Twiggs Union Upson Walker Walton Ware Warren Washington Wayne Webster Wheeler White Whitfield Wilcox Wilkes Wilkinson Worth GEORGIA Population PRIMARY CARE (Generalists) OB/GYN TOTAL General Surgery ALL SPEC. Family Practice Internal Medicine Pediatrics 2006 # Rate2 Rank3 # Rate Rank # Rate Rank # Rate Rank # Rate Rank # 8,716 1 11.5 126 0 0 108 0 0 13,247 5 37.7 37 3 22.6 40 0 0 10,561 2 18.9 104 1 9.5 92 0 0 44,263 17 38.4 34 12 27.1 32 10 22.6 40,467 10 24.7 83 12 29.7 23 11 27.2 26,932 8 29.7 60 6 22.3 42 9 33.4 10,270 6 58.4 12 2 19.5 52 0 0 6,749 1 14.8 117 0 0 108 0 0 62,295 8 12.8 122 14 22.5 41 8 12.8 9,454 3 31.7 53 0 0 108 0 0 10,481 0 0 136 0 0 108 0 0 19,827 10 50.4 15 2 10.1 89 1 5.0 27,485 5 18.2 108 4 14.6 74 4 14.6 63,239 16 25.3 77 1 1.6 107 0 0 75,543 14 18.5 105 14 18.5 58 5 6.6 34,966 14 40.0 30 19 54.3 4 9 25.7 6,077 1 16.5 110 2 32.9 19 0 0 19,947 5 25.1 79 10 50.1 6 2 10.0 28,309 8 28.3 66 3 10.6 88 3 10.6 2,250 0 0 136 0 0 108 0 0 6,574 2 30.4 57 0 0 108 0 0 23,793 6 25.2 78 0 0 108 0 0 90,512 26 28.7 64 25 27.6 30 16 17.7 8,610 0 0 136 1 11.6 85 0 0 10,344 3 29.0 62 3 29.0 25 2 19.3 10,111 3 29.7 60 1 9.9 91 0 0 21,442 9 42.0 27 3 14.0 76 3 14.0 9,109,209 2,391 2,471 1,548 82 0 0 80 0 0 82 0 0 80 0 0 82 0 0 80 0 0 12 6 13.6 26 7 15.8 6 7 17.3 13 4 9.9 3 5 18.6 10 2 7.4 82 0 0 80 0 0 82 0 0 80 0 0 41 10 16.1 21 5 8.0 82 0 0 80 0 0 82 0 0 80 0 0 78 0 0 80 1 5.0 34 2 7.3 53 3 10.9 82 1 1.6 77 1 1.6 73 2 2.6 72 5 6.6 7 6 17.2 14 5 14.3 82 0 0 80 0 0 55 2 10.0 38 4 20.1 50 2 7.1 55 2 7.1 82 0 0 80 0 0 82 0 0 80 0 0 82 1 4.2 70 1 4.2 5 17 18.8 9 8 8.8 82 0 0 80 0 0 17 1 9.7 40 0 0 82 0 0 80 0 0 36 0 0 80 1 4.7 1,027 699 72 2 72 8 72 3 7 148 26 90 41 53 72 12 72 1 39 104 72 4 72 1 57 28 22 35 69 31 46 60 10 129 72 4 4 29 43 29 72 0 72 2 62 10 33 189 72 1 72 12 72 4 59 19 18,422 1 Source: Composite State Board of Medical Examiners, Georgia Physician Survey, 2006. 2 Rate per 100,000 population 3 Rate by Rank 22 Metropolitan and Non-Metropolitan Statistical Areas in Georgia DADE CATOOSA WHITFIELD WALKER MURRAY CHATTOOGA GORDON FANNIN TOWNS UNION RABUN GILMER PICKENS LUMPKIN WHITE HABERSHAM STEP- HENS DAWSON FRANKLIN HALL BANKS HART FLOYD BARTOW CHEROKEE FORSYTH JACKSON ELBERT MADISON POLK PAULDING COBB HARALSON GWINNETT BARROW CLARKE WALTON OCONEE OGLETHORPE WILKES LINCOLN DOUGLAS FULTON DEKALB ROCKDALE CARROLL CLAYTON NEWTON MORGAN GREENE TALIAFERRO COLUMBIA MCDU- FFIE FAYETTE COWETA HENRY JASPER PUTNAM WARREN RICHMOND HEARD SPALDING BUTTS HANCOCK GLASCOCK TROUP MERIWETHER PIKE LAMAR MONROE BALDWIN JONES JEFFERSON WASHINGTON BURKE HARRIS UPSON TALBOT CRAWFORD BIBB WILKINSON TWIGGS JOHNSON JENKINS EMANUEL SCREVEN MUSCOGEE TAYLOR PEACH MARION MACON HOUSTON BLECKLEY CHATTAHOOCHEE SCHLEY PULASKI DODGE DOOLY STEWART WEBSTER SUMTER WILCOX CRISP QUITMAN TERRELL LEE RANDOLPH TURNER BEN HILL LAURENS TREUTLEN CANDLER BULLOCH EFFINGHAM MONTGOM- EVANS WHEELER ERY TOOMBS TATTNALL BRYAN TELFAIR JEFF DAVIS APPLING LIBERTY LONG CHATHAM CLAY CALHOUN DOUGHERTY WORTH IRWIN TIFT COFFEE EARLY BAKER BERRIEN ATKINSON MILLER MITCHELL SEMINOLE DECATUR GRADY COLQUITT COOK LANIER THOMAS BROOKS LOWNDES CLINCH BACON WAYNE MCINTOSH PIERCE WARE BRANTLEY GLYNN CHARLTON CAMDEN ECHOLS Metropolitan Statistical Areas (MSA) (Urban) Non-Metropolitan Statistical Areas (Non-MSA) (Rural) 23 Glossary of Terms Adequate- Category of physician distribution meaning there are enough physicians in that specialty, based on the +/- 1 standard deviation of the physician rate per 100,000. Core Specialties- Five specialties including: family practice, internal medicine, pediatrics, OB/GYN and general surgery. Deficit- Category of physician distribution meaning there are not enough physicians in that specialty, based on the +/- 1 standard deviation of the physician rate per 100,000. Generalist- Includes family practice, internal medicine and pediatrics. Same as "primary care". Metropolitan Statistical Area (MSA)- Contains a core urban area of 50,000 or more population. Defined by the U.S. Office of Management and Budget (OMB). Also referred to as urban. Non-Metropolitan Statistical Area (Non-MSA)- The areas that are not defined as Metropolitan Statistical Areas as defined by the U.S. Office of Management and Budget (OMB). Also referred to as rural. Primary Care- Group of specialties that include family practice, internal medicine and pediatrics. Primary Care Service Area- Ninety-six (96) areas were designated by the 30% rule using the Georgia Hospital Questionnaire ie. (1) a PCSA was designated if at least 30% of the patients received care in their county of residence or (2) if a county received less than 30% of its residents as patients, it was assigned to the county where the majority of its residents go for primary care. Specialist- All physician specialties other than family practice, internal medicine, and pediatrics. Surplus- Category of physician distribution meaning there are more than and adequate amount of physicians in that specialty, based on the +/- 1 standard deviation of the physician rate per 100,000. 24 GEORGIA BOARD FOR PHYSICIAN WORKFORCE BOARD MEMBERS Ralph Austin, Jr., M.D. Chairman Joe Sam Robinson, Jr., M.D. Vice Chairman James R. Lowry Secretary/Treasurer Brian K. Burdette Edward D. Conner, M.D. Jacinto del Mazo, M.D. J. Daniel Hanks, Jr., M.D. Thomas L. Hatchett, Jr., M.D. Gilbert S. Klemann, M.D. D. Wayne Martin, MBA E. Chandler McDavid, M.D. Reuben S. Roberts, Jr., M.D. Cherri Tucker, Executive Director for the Georgia Board for Physician Workforce and the State Medical Education Board BOARD STAFF Colette Caldwell, Usha Caudill, Carla Graves, Kim Jackson, Olive Jones-Golden, and Kelly McNamara ACKNOWLEDGMENTS The Board would like to thank G.E. Alan Dever, M.D., Ph.D., M.T. of Health Services Analysis, Inc. for his contributions to this report. The Board would also like to express appreciation to LaSharn Hughes, Executive Director of the Composite State Board of Medical Examiners (CSBME), and to the CSBME staff, for their support of these efforts. 1718 Peachtree St., N.W. Suite 683, Atlanta, GA 30308, www.gbpw.georgia.gov