PHYSICIAN WORKFORCE* Primary Care/Core Specialties *Based on 2008 Licensure Data Georgia Board for Physician Workforce State of Georgia July 2011 Executive Summary The 2008 Physician Workforce Profile marks the 22nd year the Georgia Board for Physician Workforce (GBPW) 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 assess the healthcare needs of Georgia's citizens. Between 2006 and 2008, Georgia's physician workforce experienced a gain in both primary care/ core specialties (family medicine, internal medicine, pediatrics, OB/GYN, and general surgery), and specialists. However, in 2008 there was a larger percent of the workforce in specialized categories. Between 1998 and 2008, the population in Georgia increased by 24.8%. The overall rate of physician increase was 29.2% between 1998 and 2008 (slightly higher than the population increase). The rate of increase for physicians in the five primary care/core specialties was 21.6%. The rate of increase of specialist physicians was 35.9% during the ten year period. All primary care/core specialty physicians gained in number between 2006 and 2008, although the rate per 100,000 population decreased for internal medicine, pediatrics, OB/GYN and general surgery. The rate of family medicine physicians increased slightly. The percentage of specialty physicians was the highest in 2008. In 2008, the rates of physicians in Metropolitan Statistical Areas (MSAs) were higher than in Non-Metropolitan Statistical Areas (Non-MSAs) in all of the primary care/core specialties except for family medicine. Fifty-two percent of all Georgia's physicians are located in five Primary Care Service Areas (PCSAs). These five PCSAs represent 38.1% 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. Pediatrics had the highest percentage of female physicians. This is the only specialty where females constitute >50% of the workforce. Surgical specialties have the lowest percentage of females in the workforce. Females comprise 8.3% of the general surgery workforce. The percentage of white physicians has decreased steadily from 1998 to 2006, while all other races have increased during this time period. The physician workforce is aging. In 2008, 30.7% of the physician workforce was 55 and over. In comparison, 22.8% of the workforce was 55 and over in 1998. Of the five primary care/core specialties, general surgery had the largest percentage (37.5%) of physicians age 55 and over. Family medicine had the second highest percentage of physicians 55 and over with 32.5%. Pediatrics had the youngest cohort of physicians, with 10.3% being less than 35 years old. There was a decrease in the percentage of physicians accepting Medicaid and Medicare between 2006 and 2008. Also, there was a decrease in the percentage of physicians accepting new Medicaid and new Medicare patients. More than one-third (34.1%) of the workforce are not accepting new Medicaid patients. PHYSICIAN PROFILE 2008 Distribution of Physicians, U.S. 2008* per 100,000 population Excellent Good Fair Poor In 2008 Georgia ranked 40th among all states. *Source American Medical Association, Physician Characteristics and Distribution in the U.S. 2010 Edition, 2008. 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 1998 and 2008, the population in Georgia increased by 24.8%. The rate of physician increase during the same years was 29.2% (slightly higher than the population increase). To illustrate how Georgia compares to the nation, Georgia's physician rate per 100,000 population was 200 for 2008 and the national rate was 309 physicians per 100,000 population. Physician Supply in Georgia 1998-2008 Number in Thousands Rate Physicians in Georgia - Number 25 20 14,739 15 15,736 16,483 17,513 18,422 19,046 10 Georgia's Physician Supply - Rate* 250 200 193 192 193 202 202 200 150 100 5 50 0 1998 2000 2002 2004 2006 2008 0 1998 2000 2002 2004 2006 2008 *Rate per 100,000 1 PHYSICIAN SPECIALTIES IN GEORGIA Georgia Physician Workforce 2006 & 2008 Selected Specialties by MSA/ Non-MSA Designation Specialty 2006 MSA Non-MSA Number Rate* Number Rate* 2008 MSA Non-MSA Number Rate* Number Rate* Family Medicine 1,835 24.8 556 32.3 1,960 25.3 564 31.4 Internal Medicine 2,109 28.5 362 21.0 2,148 27.8 352 19.6 Pediatrics 1,371 18.6 177 10.3 1,424 18.4 159 8.9 OB/GYN 892 12.1 135 7.8 907 11.7 134 7.5 General Surgery 582 7.9 117 6.8 606 7.8 124 6.9 *Rate per 100,000 population Generalists vs. Specialists Over the last ten years "other specialties" has achieved its highest percentage at 56% in 2008. Rates for family medicine, internal medicine, pediatrics, OB/GYN, and general surgery all decreased between 2004 and 2006, but remained somewhat constant between 2006 and 2008. T10h0e percentage of "other specialties" de8c0reased steadily from 1998 to 2002. T6h0ere was a 4.2% 2004 and 2008. increase between East 40 West North T2h0e percentage of generalists was the lowest in 2008. Historically, the largest dec0 re1astsQetr 2nidnQtr g3rednQetrra4ltihstQstr occurred between 2004 and 2006. 2 Primary Care/Core Specialists Percent of Generalists & Specialists by Year 1998-2008 PHYSICIAN RATE DISTRIBUTION OF PHYSICIANS BY PCSA* Dade Catoosa 1 Whitfield 2 Walker Murray Chattooga Gordon 16 Fannin 4 3 Union 5 Gilmer Pickens 14 Lu1m2pkin Dawson Towns 6 Rabun 7 White Habersham- Stephens 10 8 11 Franklin Banks 9 Hall Hart 28 Excellent (>163) Good (124 - 162.9) Fair (87 - 123.9) Poor (<87) 18 Floyd Bartow 17 Cherokee 15 Forsyth 13 Jackson Madison 27 Elbert 29 Polk 21 Paulding Cobb Gwinnett 25 Barrow Walton Clarke Oconee Oglethorpe Wilkes Haralson 19 20 22 23 24 26 34 30 31 Carroll Douglas Dekalb Fulton Rockdale Clayton Newton Morgan Lincoln Greene Taliaferro Columbia McDuffie 41 4039 38 36 35 32 Heard Coweta Fayette Henry Spalding Butts Jasper Putnam Warren Hancock Glascock 42 37 47 33 49 50 Troup Meriwether Pike Lamar Monroe Jones Baldwin Jefferson Washington Richmond Burke 44 45 46 48 54 Upson Bibb Wilkinson Johnson Jenkins Harris Talbot Crawford Twiggs Emanuel Screven 51 43 Muscogee Marion Taylor Peach 67 Macon Houston Bleckley 63 Laurens 60 57 Treutlen 55 Candler 53 Bulloch Effingham Chattahoochee Stewart Schley 68 66 Dooly Pulaski 64 Dodge 62 59 Montgomery Wheeler 58 56 Evans Tattnall 52 Bryan Chatham Webster 69 Sumter Quitman 70 Terrell Lee Randolph 65 Wilcox Crisp Turner Ben Hill 87 Telfair 61 Toombs Jeff 89Davis Appling 91 Long 92 Liberty Clay 76 Calhoun Dougherty Early 71 Baker Miller 72 Seminole Decatur 73 Mitchell Grady 74 79 Irwin 86 W orth 77 Tift 85 78 Colquitt Berrien 80 Cook Coffee 88 Atkinson 84 Lanier 83 Clinch Thomas 75 Brooks 81 82 Lowndes Echols Bacon 90 Wayne McIntosh 94 PPiIeErcReCE Ware Brantley 93 Glynn Charlton 95 Camden 96 In 2008, Georgia's physician rate per 100,000 population was 200; compared to the rate of 193 in 1998. 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 75: Thomas 4. Area 23: DeKalb 5. Area 47: Baldwin 6. Area 46: Bibb, Crawford, Jones, Peach, Taylor, Twiggs, Wilkinson 7. Area 94: Pierce, Ware 8. Area 43: Chattahoochee, Harris, Marion, Muscogee, Talbot 9. Area 52: Bryan, Chatham, Effingham, Liberty 10. Area 18: Chattooga, Floyd, Polk Fifty-two percent of all Georgia's physicians are located in Rates are per 100,000 population five PCSAs. These five PCSAs represent 38.1% of the state's population. * Primary Care Service Areas (PCSAs) are included as a geography in the 2008 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 1998-2008 2,027 2,143 2,171 2,293 2,391 2,524 1,971 2,264 2,509 2,652 2,471 2,500 1,280 1,402 1,495 1,588 1,548 1,583 903 986 1,138 1,171 1,027 1,041 708 771 726 733 699 730 7,850 8,170 8,444 9,076 10,286 10,668 3,000 2,500 2,000 1,500 1,000 500 0 Family Medicine Pediatrics Internal Medicine 1998 2000 2002 2004 12,000 10,000 8,000 6,000 General Surgery OB/GYN 4,000 2,000 2006 2008 0 3 Other Specialties Georgia Physician Workforce: Total Physicians by Specialty and Rate*, 1998-2008 Specialty 1998 2000 2002 2004 2006 2008 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 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 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 1.24 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 1.31 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 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 1.04 8.95 6.79 2.94 9.66 1.30 26.47 3.68 7.66 2.94 2.21 26.22 1.36 2.62 1.50 3.31 11.27 2.63 1.37 3.42 10.92 Oncology 1.57 1.58 1.75 2.08 2.57 2.57 Ophthalmology 4.92 4.75 4.64 4.67 4.70 4.68 Orthopedic Surgery 7.20 6.79 6.89 7.04 7.47 7.22 Otorhinolaryngology 3.02 3.11 2.88 3.12 3.07 3.07 Pain Medicine Not 0.17 0.79 0.79 1.24 1.32 Listed Pathology 4.41 4.51 4.43 4.55 3.80 3.79 (all Pathologies combined for 2006 & 2008) Pediatrics 16.75 17.13 17.46 18.28 16.99 16.60 Physical Medicine & 1.45 1.45 Not 0.28 1.40 1.32 Rehabilitation Listed Plastic Surgery 1.87 1.82 2.13 2.31 2.29 2.37 Psychiatry 11.04 11.14 10.45 10.53 11.15 11.07 Public Health 1.52 1.16 0.80 0.86 1.25 1.24 Pulmonary Diseases 1.92 1.92 1.67 1.89 2.92 2.86 Radiology 8.97 9.10 8.32 8.50 8.60 8.63 (Diagnostic Radiology & Radiology combined) Rheumatology 0.76 0.75 0.60 0.72 0.96 0.87 Therapeutic Radiology 0.86 0.67 1.06 1.09 1.40 1.34 Thoracic Surgery 0.42 0.43 1.08 1.08 0.74 0.72 Urological Surgery 3.42 3.04 3.06 2.97 3.04 3.05 State Total** 193 192 193 202 202 200 * Rate per 100,000 population: Population for 1998-2008: Governor's Office of Planning and Budget (http://www.opb.state.ga.us) ** All physicians 4 Rate per 100,000 Physician Rates by Primary Care/Core Specialties: 1998-2008 35 30 26.52 27.66 29.30 30.53 27.12 26.47 Family Medicine 25 20 25.79 26.18 25.36 26.40 26.24 26.22 Internal Medicine Pediatrics 15 10 5 16.75 11.82 9.26 17.13 12.04 9.42 17.46 13.29 8.48 18.28 13.48 8.44 16.99 11.27 7.67 16.60 10.92 7.66 OB/GYN General Surgery 0 1998 2000 2002 Year 2004 2006 2008 DEMOGRAPHICS _ Accepting Medicare and Medicaid 84.6 85.4 78.3 81.3 80.6 78.8 85.3 85.4 77.3 79.2 78.1 73.8 100% 80% 60% 40% 20% 0% 1998 Medicare 2000 2002 Medicaid 2004 2006 2008 ______ All Specialties New Medicaid and Medicare Patients 2006 & 2008 (Percent) 2006 2008 Accept New Yes No Yes No Patients: New Medicare 76.4% 23.6% 74.0% 26.0% New Medicaid 70.7% 29.3% 65.9% 34.1% 80.0 79.0 79.1 79.4 73.9 73.6 20.0 21.0 20.9 20.6 26.1 26.4 Gender 100% 80% 60% 40% 20% 0% Race 100% 80% 60% 40% 20% 0% 80.2 79.0 77.4 77.1 74.8 74.4 Male 1998 2004 2000 2006 2002 2008 Female 1998 2000 2002 2004 2006 2008 8.9 10.3 11.9 12.7 13.4 13.3 7.8 8.1 7.7 6.8 7.2 7.0 3.1 2.6 3.0 3.4 4.6 5.3 White Black Asian 5 Other 1998 2000 2002 2004 2006 2008 6 60-64 65 and Over 55-59 50-54 45-49 40-44 35-39 30% 25% 20% 15% 10% 5% 0% Less Than 35 26.0 26.2 15.313.2 9.2 14.3 19.8 19.9 17.6 17.5 19.2 17.2 18.4 17.9 17.7 17.5 17.8 18.4 13.4 15.0 18.0 15.9 15.8 16.4 7.7 8.0 14.6 15.7 14.4 15.6 5.3 5.0 7.3 8.0 9.2 11.3 2.9 3.1 5.4 4.9 4.0 5.0 6.5 4.9 6.2 5.2 5.2 6.7 INTERNAL MEDICINE 1998 2000 2002 2004 2006 2008 65 and Over 60-64 55-59 50-54 45-49 40-44 35-39 15.4 15.6 11.9 14.0 5.9 11.0 16.5 16.0 12.9 14.5 17.4 17.4 19.2 18.0 15.1 13.4 14.0 13.9 14.9 16.6 18.2 17.6 15.6 14.0 11.2 12.0 14.9 14.9 15.8 16.2 8.7 8.6 9.1 9.6 11.4 12.9 6.2 6.0 5.4 5.3 6.1 7.8 7.9 7.2 12.3 10.7 8.7 11.8 30% 25% 20% 15% 10% 5% 0% Less Than 35 FAMILY MEDICINE 1998 2000 2002 2004 2006 2008 60-64 65 and Over 55-59 50-54 45-49 40-44 35-39 30% 25% 20% 15% 10% 5% 0% Less Than 35 15.4 15.6 10.2 12.9 7.2 11.6 16.5 16.0 14.7 14.9 15.2 14.5 19.2 18.0 17.4 16.4 15.5 14.8 14.9 16.6 18.5 17.4 16.7 16.3 11.2 12.0 14.1 14.2 15.4 16.5 8.7 8.6 9.9 9.8 11.0 12.1 6.2 6.0 6.8 6.6 7.1 8.2 7.9 7.2 8.6 7.8 7.6 10.4 TOTAL PHYSICIANS Distribution by Age and Specialty Specialties DEMOGRAPHICS 7 55-59 2006 2008 1998 2000 2002 2004 65 and Over 60-64 50-54 45-49 40-44 35-39 30% 25% 20% 15% 10% 5% 0% Less Than 35 13.7 19.8 10.6 13.0 6.4 11.8 15.1 14.4 11.1 12.3 13.0 12.9 16.2 14.9 14.8 14.4 13.5 12.1 12.4 12.8 15.9 15.9 16.0 15.5 11.3 10.5 11.9 12.6 14.2 15.6 11.5 9.2 11.1 10.8 11.2 10.5 8.8 8.6 10.6 9.5 9.1 10.0 11.0 9.7 14.0 11.211.5 17.0 GENERAL SURGERY 1998 2000 2002 2004 2006 2008 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 16.2 19.6 11.7 14.0 7.1 11.9 18.8 17.4 16.6 17.3 18.9 16.7 20.6 18.7 18.1 16.9 18.1 17.4 13.1 14.6 17.1 16.8 16.6 16.8 12.5 11.1 11.8 12.3 13.1 17.4 8.2 9.1 10.9 9.5 10.6 10.1 5.7 4.6 6.4 7.0 6.6 6.9 4.8 5.0 7.4 6.3 4.2 7.6 OB/GYN 1998 2000 2002 2004 2006 2008 65 and Over 60-64 55-59 50-54 45-49 40-44 35-39 20.6 20.9 13.9 16.4 10.6 16.0 18.0 16.2 16.2 17.5 18.1 17.1 17.9 17.6 17.5 16.9 16.5 16.0 15.1 16.2 16.2 21.1 16.2 16.9 10.4 10.3 13.3 12.9 12.8 14.3 6.7 7.5 9.6 8.8 8.4 10.4 5.0 5.3 5.8 6.0 6.0 6.8 6.5 6.0 7.0 6.3 5.9 8.0 30% 25% 20% 15% 10% 5% 0% Less Than 35 Distribution by Age and Specialty PEDIATRICS Specialties DEMOGRAPHICS FAMILY MEDICINE PROFILE - 2008 TOP 10 PRIMARY CARE SERVICE AREAS (PCSAs) BY NUMBER OF FAMILY MEDICINE PHYSICIANS RANK* 1. Area 22: Fulton (224) 2. Area 23: DeKalb (190) 3. Area 21: Cobb, Paulding (147) 4. Area 25: Gwinnett (146) 5. Area 31: Columbia, Lincoln, Richmond (137) 8 3 4 10 2 1 6. Area 43: Chattahoochee, Harris, Marion, Muscogee, Talbot (135) 7. Area 52: Bryan, Chatham, Effingham, Liberty (111) 9 8. Area 18: Chattooga, Floyd, Polk (91) 9. Area 46: Bibb, Crawford, Jones, Peach, Taylor, 6 Twiggs, Wilkinson (90) 10. Area 27: Barrow, Clarke, Jackson, Madison, Morgan, Oconee, Oglethorpe (78) * Numbers correspond to rank. ** Numbers in parenthesis represent the number of physicians. 5 7 PIERCE Family Medicine Physician Supply 3,000 2,500 2,000 2,524 2,027 2,143 2,171 2,293 2,391 Number 1,500 1,000 500 0 1998 2002 2006 2000 2004 2008 8 Between 1998 and 2008, the number of family medicine physicians in Georgia increased 24.5%. In 2008, there was at least one family medicine physician in every PCSA. The greatest increase in family medicine physicians (in number) was between 2006 and 2008. The top 10 PCSAs for number of practicing family medicine physicians have all or most of the area located in a Metropolitan Statistical Area. Family Medicine Family Medicine Physician Distribution - 2008 Deficit, Adequate, and Surplus PCSAs* 1 2 Dade Catoosa Whitfield Walker Murray Chattooga G1o6rdon Floyd 18 Bartow 17 6 Fannin Towns Union Rabun 3 4 5 7 Gilmer 14 12 11 10 89 28 Pickens Lumpkin White Habersham Stephens Dawson Franklin Hart Banks Hall Cherokee Forsyth 15 13 27 29 Jackson Madison Elbert Deficit Adequate Surplus 21 Polk Gwinnett Barrow Clarke Cobb 25 Paulding 23 Haralson Walton Oconee Oglethorpe Wilkes Lincoln 19 20 22 24 26 30 31 Carroll 41 40 38 36 35 3433 32 Heard Douglas Fulton Dekalb Clayton- 39 Rockdale Newton Morgan Greene Taliaferro Columbia McDuffie Fayette Coweta Henry Jasper Putnam Spalding Butts Warren Hancock Glascock Richmond Burke 37 Meriwether Baldwin Jefferson 42 47 49 50 Pike Lamar Monroe Jones Washington 44 45 Troup 46 48 54 Harris Upson Bibb Wilkinson Talbot Crawford Twiggs Jenkins Johnson Emanuel Screven 51 43 57 53 Muscogee Taylor Peach Laurens 67 60 55 Marion 63 Chattahoochee Houston Bleckley Macon 66 59 58 56 Schley Pulaski Dodge Treutlen Bulloch Candler Montgomery Evans Effingham Stewart 68 Dooly 64 62 Wheeler Toombs 52 Bryan Chatham 69Webster Sumter 70 Quitman Terrell Lee Randolph 65 Wilcox Crisp 87 Ben Hill Turner Telfair 61 Jeff Davis 89 Tattnall Liberty Appling 91 Long 92 Clay Early 71 76 Calhoun Dougherty Baker 79 Worth Irwin 86 77 Tift 85 78 Berrien 80 Coffee 88 Atkinson Bac9on0 Wayne McIntosh 94 PPieIErRcCeE 93Glynn Brantley Ware Miller 72 Seminole Decatur Mitchell Grady Colquitt Cook 84 83 Lanier Clinch Thomas Brooks Lowndes Charlton 95 Camden 96 73 74 75 81 82 Echols In 2008, there are the same number of PCSAs with a physician deficit, as in 2006. The top three areas of surplus are: Area 55: Candler Area 4: Fannin Area 90: Bacon The bottom three areas of deficit are: Area 86: Irwin Area 36: Jasper, Newton Area 39: Clayton The adequate range for family medicine physicians in PCSAs in 2008 (based on +/- 1.0 standard deviation) is 13.1 to 39.9. There are 74 PCSAs that have an adequate number of family medicine physicians, but geographic distribution continues to be a problem. In 2008, there was a slight increase in the rate of family medicine physicians per 100,000 population and an increase in number. * 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 2008. Family Medicine Physicians (by Gender) 100% 79.4 79.0 80% 77.4 77.7 71.0 70.0 60% 40% 29.0 30.0 20.6 21.0 22.6 22.3 20% Family Medicine Physicians by Gender, MSA/Non-MSA and Year (percent) GENDER MSA Male Female Non-MSA Male Female 2006 68.2 31.8 79.8 20.2 2008 67.7 32.3 78.2 21.8 0% 1998 2000 2002 Male 2004 2006 Female 2008 9 INTERNAL MEDICINE PROFILE - 2008 TOP 10 PRIMARY CARE SERVICE AREAS (PCSAs) BY NUMBER OF INTERNAL MEDICINE PHYSICIANS RANK* 1. Area 22: Fulton (554) 2. Area 23: DeKalb (277) 3. Area 21: Cobb, Paulding (163) 4. Area 25: Gwinnett (138) 5. Area 31: Columbia, Lincoln, Richmond (138) 6. Area 52: Bryan, Chatham, Effingham, Liberty (100) 7. Area 46: Bibb, Crawford, Jones, Peach, Taylor, Twiggs, Wilkinson (75) 8. Area 27: Barrow, Clarke, Jackson, Madison, Morgan, Oconee, Oglethorpe (69) 9. Area 11: Dawson, Hall, White (55) 10. Area 43: Chattahoochee, Harris, Marion, Muscogee, Talbot (48) * Numbers correspond to rank. ** Numbers in parenthesis represent the number of physicians. 9 3 4 8 2 1 7 10 5 6 PIERCE Internal Medicine Physician Supply Number 3,000 2,500 2,000 2,652 2,506 2,471 2,500 2,264 1,971 1,500 1,000 500 0 1998 2002 2006 2000 2004 2008 10 Between 1998 and 2008, the number of internal medicine physicians in Georgia increased 26.8%. In 2008, there were three PCSAs that had no internal medicine physicians in their region. This includes the following counties: Quitman, Randolph, Stewart, Webster, and Wheeler. Internal medicine experienced a decrease in the rate per 100,000 population in 2006 and 2008. The top 10 PCSAs for number of practicing internal medicine physicians have all or most of the area located in a Metropolitan Statistical Areas. Internal Medicine Internal Medicine Physician Distribution - 2008 Deficit, Adequate, and Surplus PCSAs* Dade Catoosa Whitfield Fannin Towns Rabun Union 1 2 3 4 5 6 7 Walker 16 12 11 10 8 Chattooga 18 17 1154 13 9 28 Floyd Murray Gordon Bartow Gilmer White Habersham Pickens Lumpkin Dawson Hall Stephens Banks Franklin Hart Cherokee Forsyth Jackson Elbert Madison 27 29 Polk 21Cobb 25 Paulding Haralson Gwinnett Barrow Clarke Oglethrope Dekalb Oconee Walton 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 Putnam Warren Hancock Glascock Richmond 42 37 3547 33 50 Meriwether Pike Lamar Monroe 49 Troup Baldwin Jones Jefferson Washington Burke 44 45 46 48 54 Harris Upson Bibb Wilkinson Talbot Crawford Twiggs Jenkins Johnson Emanuel Deficit Adequate Surplus Screven 51 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 68 64 62 52 Stewart 69 65 Webster Sumter Dooly Pulaski Wilcox Dodge Wheeler Telfair Jeff Toombs Evans Tatnall Bryan Liberty Chatham 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 I8rw6in Coffee Worth 77 Tift 85 88 78 Berrien 80 Atkinson Colquitt Cook 83 84 Lanier Clinch Decatur Grady Thomas Brooks 73 74 75 81 Lowndes82 Echols Bacon 90 Wayne McIntosh PPIiEeRrCcEe 94 Ware 93 Glynn Brantley 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 2008. In 2008, there are six more PCSAs in deficit than in 2006. The top three areas of surplus are: Area 22: Fulton Area 47: Baldwin Area 31: Columbia, Lincoln, Richmond The bottom three areas of deficit are: Area 59: Wheeler Area 69: Stewart, Webster Area 70: Quitman, Randolph The adequate range for internal medicine physicians in PCSAs in 2008 (based on +/- 1.0 standard deviation) is 16.4 to 36.0. There are 55 PCSAs that have an adequate number of internal medicine physicians, and 33 that have a deficit. Internal Medicine Physicians (by Gender) 100% Internal Medicine Physicians by Gender, MSA/Non-MSA and Year (percent) 80% 76.9 76.5 60% 78.7 78.1 69.2 68.5 40% 30.8 31.5 23.1 23.5 21.3 21.9 20% GENDER MSA Male Female Non-MSA Male Female 2006 67.3 32.7 80.3 19.7 2008 66.8 33.2 78.7 21.3 0% 1998 2000 2002 Male 2004 2006 Female 2008 11 PEDIATRICS PROFILE - 2008 TOP 10 PRIMARY CARE SERVICE AREAS (PCSAs) BY NUMBER OF PEDIATRICIANS RANK* 1. Area 22: Fulton (290) 2. Area 23: DeKalb (235) 3. Area 25: Gwinnett (138) 4. Area 21: Cobb, Paulding (120) 5. Area 31: Columbia, Lincoln, Richmond (98) 6. Area 52: Bryan, Chatham, Effingham, Liberty (73) 7. Area 46: Bibb, Crawford, Jones, Peach, Taylor, Twiggs, Wilkinson (38) 8. Area 39: Clayton (37) 9. Area 27: Barrow, Clarke, Jackson, Madison, Morgan, Oconee, Oglethorpe (37) 10. Area 43: Chattahoochee, Harris, Marion, Muscogee, Talbot (32) * Numbers correspond to rank. ** Numbers in parenthesis represent the number of physicians. 4 3 9 2 18 7 10 5 6 PIERCE Number Pediatrician Physician Supply 2,000 1,500 1,495 1,588 1,548 1,583 1,402 1,280 1,000 500 0 1998 2002 2006 2000 2004 2008 12 Between 1998 and 2008, the number of pediatricians in Georgia increased 23.7%. In 2008, there were 22 PCSAs that did not have a pediatrician in their region (this is approximately 22.9% of the state's PCSAs and 3.4% of Georgia's population). The number of pediatricians increased slightly between 2006 and 2008; however, the rate has decreased in 2006 and 2008. The top four PCSAs for number of practicing pediatricians are in the Atlanta Metropolitan Statistical Area. Pediatrics Pediatrics Physician Distribution - 2008 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 18 1167 1154 11 10 9 28 Surplus Floyd Murray Gordon Bartow Gilmer White Habersham Lumpkin Pickens Stephens Dawson Banks Franklin Hart Cherokee Forsyth 13 Hall Jackson Elbert Madison 21 27 29 Polk Cobb Paulding 25 Haralson Gwinnett Dekalb Barrow Walton Clarke Oglethorpe Oconee Wilkes Lincoln 23 26 30 Douglas Fulton Rockdale 19 20 22 24 34 31 Carroll Clayton 39 Newton Morgan Greene Taliaferro Columbia McDuffie 41 4037 38 36 35 33 32 Heard Coweta Fayette Henry Spalding Butts Putnam Jasper Warren Hancock Glascock Richmond Baldwin Jefferson Burke 42 47 50 Pike Lamar Monroe 44 45 49 Troup Meriwether Jones Washington 46 48 54 Upson Bibb Wilkinson Jenkins Screven Harris Talbot Crawford Twiggs Johnson 51 Emanuel 43 57 53 Taylor Peach Laurens 55 Muscogee Bleckley 67 63 60 Marion Chattahoochee Macon Houston Pulaski 66 59 56 Schley 68 64 62 58 52 Stewart Dooly 69Webster Sumter Wilcox Dodge Treutlen Bulloch Effingham Candler Montgomery Wheeler Telfair Evans Tattnall Toombs Bryan Liberty Chatham 70 65 61 Quitman Terrell Lee Crisp Ben Hill Jeff Davis Appling Long 87 89 91 92 Randolph Turner Irwin Coffee Bacon Wayne McIntosh 79 86 90 Clay Calhoun Dougherty 71 76 77 85 88 94 93 Early Baker Worth Tift Berrien 78 80 Miller Mitchell Colquitt Cook Atkinson PPieIErRcCeE Ware Brantley Glynn 72 84 83 Seminole 73 74 75 81 82 95 96 Decatur Grady Thomas Lanier Clinch Brooks Lowndes Echols Charlton Camden * 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 2008. In 2008, there were 53 (55.2%) of the PCSAs in deficit. This worsened since 2006, where 48 (50.0%) PCSAs were in deficit. The top three areas of surplus: Area 23: DeKalb Area 31: Columbia, Lincoln, Richmond Area 22: Fulton There are 22 PCSAs that have no pediatricians. These areas include 25 counties (Bacon, Berrien, Candler, Clinch, Cook, Early, Elbert, Evans, Grady, Hancock, Hart, Jeff Davis, Jenkins, Lanier, Pickens, Quitman, Rabun, Randolph, Screven, Stewart, Tattnall, Telfair, Towns, Webster, Wheeler). The adequate range for pediatric physicians in PCSAs in 2008 (based on +/- 1.0 standard deviation) is 10.1 to 23.1. The number of PCSAs, with a surplus, remained the same between 2006 and 2008. Pediatricians (by Gender) 100% 80% 57.9 60% 55.4 56.6 59.7 53.8 53.4 42.1 44.6 43.4 46.2 40.3 46.6 40% 20% Pediatricians by Gender, MSA/Non-MSA and Year (percent) GENDER MSA Male Female Non-MSA Male Female 2006 45.6 54.4 51.1 48.9 2008 45.5 54.5 56.3 43.7 0% 1998 2000 2002 2004 Male Female 2006 2008 13 OB/GYN PROFILE - 2008 TOP 10 PRIMARY CARE SERVICE AREAS (PCSAs) BY NUMBER OF OB/GYN PHYSICIANS RANK* 1. Area 22: Fulton (235) 2. Area 23: DeKalb (78) 3. Area 21: Cobb, Paulding (78) 4. Area 31: Columbia, Lincoln, Richmond (67) 5. Area 25: Gwinnett (61) 6. Area 52: Bryan, Chatham, Effingham, Liberty (43) 7. Area 46: Crawford, Jones, Peach, Taylor, Twiggs, Wilkinson (35) 8. Area 27: Barrow, Clarke, Jackson, Madison, Morgan, Oconee, Oglethorpe (29) 9. Area 76: Baker, Calhoun, Clay, Dougherty, Lee, Mitchell, Terrell (25) 10. Area 43: Chattahoochee, Harris, Marion, Muscogee, Talbot (25) * Numbers correspond to county code. ** Numbers in parenthesis represent the number of physicians. 3 5 8 2 1 7 10 9 4 6 PIERCE OB/GYN Physician Supply 1,500 1,138 1,171 986 1,027 1,041 1,000 903 Number 500 0 1998 2002 2006 2000 2004 2008 Between 1998 and 2008, the number of OB/GYN physicians in Georgia increased by 13.7%. During that same time, Georgia's population increased 24.8%, and Georgia's female population age 13 and over increased 22.6%.* Source: Georgia Division of Public Health http://oasis.state.ga.us In 2008, there were 28 PCSAs that had no OB/GYN in their region (this is 29.2% of the state's PCSAs and 4.5% of the state's population). The rate of OB/GYN physicians has decreased between 2004 and 2006 and between 2006 and 2008. In 2008, 87.2% of Georgia's OB/GYN physicians indicated that they delivered babies. This is a decrease from 1996, where 93.1% of OB/GYN's indicated that they delivered babies, however, the number of pregnancies in Georgia increased 19.5% between 1996 and 2008. *Source: Georgia Division of Public Health http://oasis.state.ga.us 14 OB/GYN OB/GYN Physician Distribution - 2008 Deficit, Adequate, and Surplus PCSAs* 1 2 Dade Catoosa Whitfield Fannin 34 Towns Union 5 6 Rabun 7 Deficit Walker 8 Adequate Chattooga 18 1167 1154 1312 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 21Cobb Paulding 25 Haralson Gwinnett Dekalb Barrow Walton Clarke Oglethorpe Oconee Wilkes Lincoln 19 20 22 23 26 30 31 Carroll Douglas Fulton Clayton Rockdale 24 Newton Morgan Greene Taliaferro Columbia McDuffie 39 38 36 34 32 Coweta Fayette Henry Putnam Warren Richmond 41 40 35 Heard Spalding Butts Jasper Hancock Glascock 37 33 Baldwin Jefferson Burke 42 47 50 Meriwether Pike Lamar Monroe Jones 49 Troup 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 CMhuSastttecaowhgaoeroteWcMheeabersiotenrSchlTeSayuymloMrtearconPDeoHaocolyhustoPnWulailBcsokleixckleDyodgeLauTreeWlnfashireeleTMrJreeoufnftltegTnoomoemrybsCaTnadttlnearEllvaBnsullochLibBerEyrtafyfninghaCmhatham 61 Quitman Terrell Lee Crisp Ben Hill Davis Appling Long 70 87 89 91 92 Randolph Turner Irwin Coffee Bacon Wayne McIntosh 79 86 90 Clay Calhoun Dougherty 76 77 85 88 94 Early Baker 71 78 80 93 Miller Mitchell Worth Colquitt Tift Atkinson Berrien Cook PPieIErRcCeE Ware Brantley Glynn 72 84 83 Seminole Lanier Clinch Charlton Camden 95 96 Decatur Grady Thomas Brooks Lowndes 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 2008. In 2008, there are 40 PCSAs in deficit (41.7%). This is a decrease from 2006 where 42 areas (43.8%) were in deficit. The top three areas of surplus are: Area 34: Greene Area 22: Fulton Area 64: Pulaski, Wilcox There are 28 PCSAs that have no OB/GYN physicians. These areas include 34 counties (Berrien, Bleckley, Brooks, Candler, Charlton, Clinch, Dooly, Early, Elbert, Gilmer, Glascock, Grady, Hancock, Hart, Jeff Davis, Jefferson, Jenkins, Lanier, Macon, McDuffie, Monroe, Quitman, Rabun, Randolph, Screven, Stewart, Taliaferro, Telfair, Towns, Warren, Webster, Wheeler, Wilkes, Worth). The adequate range for OB/GYN physicians in PCSAs in 2008 (based on +/- 1.0 standard deviation) is 5.7 to 16.1. OB/GYN also saw no change in the number of areas of surplus in 2008. OB/GYN Physicians (by Gender) 100% 80% 72.7 70.5 60% 71.1 69.7 60.3 61.0 39.7 39.0 40% 27.3 29.5 28.9 30.3 20% 0% 1998 2000 2002 Male 2004 2006 Female 2008 OB/GYN Physicians by Gender, MSA/Non-MSA and Year (percent) GENDER MSA Male Female Non-MSA Male Female 2006 58.6 41.4 71.8 28.2 2008 59.6 40.4 70.7 29.3 15 GENERAL SURGERY PROFILE - 2008 TOP 10 PRIMARY CARE SERVICE AREAS (PCSAs) BY NUMBER OF GENERAL SURGEONS RANK* 1. Area 22: Fulton (138) 2. Area 23: DeKalb (59) 3. Area 31: Columbia, Lincoln, Richmond (54) 4. Area 52: Bryan, Chatham, Effingham, Liberty (42) 5. Area 21: Cobb, Paulding (39) 6. Area 46: Crawford, Jones, Peach, Taylor, Twiggs, Wilkinson (28) 7. Area 43: Chattahoochee, Harris, Marion, Muscogee, Talbot (24) 8. Area 25: Gwinnett (24) 9. Area 27: Barrow, Clarke, Jackson, Madison, Morgan, Oconee, Oglethorpe (17) 10. Area 11: Dawson, Hall, White (17) * Numbers correspond to rank. ** Numbers in parenthesis represent the number of physicians. 10 5 8 9 2 1 6 7 3 4 PIERCE General Surgery Physician Supply 1,000 708 771 726 733 699 730 500 Number 0 1998 2002 2006 2000 2004 2008 Between 1998 and 2008, the number of general surgery physicians increased by 3.1%. This translates into 22 more general surgeons added during this time. This is the smallest increase of the core specialties examined in this document. In 2008, there were 22 PCSAs with no general surgery physician in their region (this is approximately 22.9% of the state's PCSAs and 3.1% of the state's population). In 2006, there were 20 PCSAs with no general surgery physician. The top five PCSAs for number of practicing general surgery physicians are in Metropolitan Statistical Areas. The rate of general surgery physicians has decreased since 2000. The number of general surgery physicians increased between 2006 and 2008, but the rate dropped slightly due to the population growing faster than the number of general surgery physicians. 16 General Surgery General Surgery Physician Distribution - 2008 Deficit, Adequate, and Surplus PCSAs* 1 2 Dade Catoosa Whitfield Walker Murray Chattooga 18 Gordon 16 Bartow 3Fannin4 Towns Union 5 6 Rabun 7 Gilmer White Habersham 12 8 Pickens Lumpkin Stephens 14 11 10 Dawson Banks Franklin 9 Cherokee Forsyth Hall Hart 28 Deficit Adequate Surplus 17 15 13 Floyd Jackson Elbert Madison 21 27 29 Polk Cobb Paulding 25 Haralson Gwinnett Dekalb Barrow Walton Clarke Oglethorpe 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 Fayette Coweta 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 Harris Upson Talbot Crawford Bibb Wilkinson Twiggs Johnson Jenkins Emanuel Screven 51 43 Muscogee Marion Chattahoochee Taylor Peach 67 Macon Houston Bleckley 63 60 57 55 53 Laurens Treutlen Candler Bulloch Effingham 66 59 56 Schley 68 64 62 58 52 Stewart Webster Sumter 69 65 61 Quitman Terrell Lee 70 87 89 91 92 Randolph Dooly Pulaski Dodge Wilcox Crisp Turner Ben Hill Montgomery Wheeler Evans Tattnall Toombs Bryan Telfair Jeff Liberty Davis Appling Long Chatham 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 95 96 Decatur Grady Thomas Brooks 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 2008. In 2008, there are 25 PCSAs in deficit (26.0%). This is down from 2006, when 27 PCSAs were in deficit. The top three areas of surplus are: Area 70: Randolph, Quitman Area 72: Miller, Seminole Area 34: Greene There are 22 PCSAs that have no general surgery physicians. These areas include 25 counties (Berrien, Bleckley, Brooks, Candler, Charlton, Clinch, Cook, Early, Franklin, Hancock, Irwin, Jefferson, Jenkins, Lanier, Monroe, Pulaski, Putnam, Screven, Stewart, Taliaferro, Towns, Webster, Wheeler, Wilcox, Wilkes). The adequate range for general surgery physicians in PCSAs in 2008 (based on +/- 1.0 standard deviation) is 3.1 to 12.3. General surgery has experienced an increase in areas of surplus in 2008 (16 in 2008, 14 in 2006, and 12 in 2004). General Surgery Physicians (by Gender) 100% 94.2 92.2 93.7 93.3 91.4 91.3 General Surgery Physicians by Gender, MSA/Non-MSA and Year (percent) 80% GENDER 2006 2008 MSA 60% Male 89.8 89.7 Female 10.2 10.3 40% Non-MSA Male 99.1 99.2 20% 5.8 7.8 6.3 6.7 8.6 8.7 Female 0.9 0.8 0% 1998 2000 2002 2004 Male Female 2006 2008 17 GEOGRAPHIC DISTRIBUTION Primary Care/Core PHYSICIANS BY SPECIALTY BY COUNTY, GEORGIA, 2008 Number, Rate and Rank NUMBER OF PHYSICIANS BY SPECIALTY 1 County Population PRIMARY CARE (Generalists) TOTAL OB/GYN General Surgery ALL SPEC. 2008 Family Practice Internal Medicine Pediatrics # Rate2 Rank3 # Rate Rank # Rate Rank # Rate Rank # Rate Rank # Appling 17,905 6 33.5 59 5 27.9 31 3 16.8 26 2 11.2 34 2 11.2 Atkinson 8,165 3 36.7 44 0 0.0 128 0 0.0 100 0 0.0 84 0 0.0 Bacon 10,564 7 66.3 10 4 37.9 14 0 0.0 100 2 18.9 13 1 9.5 Baker 3,744 1 26.7 84 2 53.4 3 0 0.0 100 0 0.0 84 0 0.0 Baldwin 46,521 16 34.4 55 23 49.4 5 6 12.9 44 6 12.9 28 7 15.0 Banks 16,443 1 6.1 153 3 18.2 69 0 0.0 100 0 0.0 84 0 0.0 Barrow 67,170 15 22.3 105 5 7.4 115 5 7.4 78 1 1.5 82 2 3.0 Bartow 92,717 27 29.1 73 17 18.3 66 6 6.5 84 5 5.4 63 6 6.5 Ben Hill 17,724 6 33.9 58 4 22.6 46 1 5.6 86 1 5.6 61 3 16.9 Berrien 16,690 6 35.9 48 1 6.0 121 0 0.0 100 0 0.0 84 0 0.0 Bibb 154,891 74 47.8 21 73 47.1 8 38 24.5 9 35 22.6 8 27 17.4 Bleckley 12,827 5 39.0 32 3 23.4 42 1 7.8 76 0 0.0 84 0 0.0 Brantley 15,434 2 13.0 143 0 0.0 128 1 6.5 83 0 0.0 84 0 0.0 Brooks 16,344 4 24.5 93 1 6.1 120 1 6.1 85 0 0.0 84 0 0.0 Bryan 30,084 6 19.9 116 6 19.9 56 3 10.0 60 2 6.6 58 0 0.0 Bulloch 66,412 14 21.1 114 12 18.1 72 9 13.6 42 9 13.6 25 4 6.0 Burke 22,823 8 35.1 52 2 8.8 110 1 4.4 91 1 4.4 70 1 4.4 Butts 23,644 5 21.1 112 6 25.4 35 2 8.5 71 0 0.0 84 0 0.0 Calhoun 5,988 4 66.8 8 0 0.0 128 1 16.7 27 0 0.0 84 0 0.0 Camden 47,365 10 21.1 113 11 23.2 43 7 14.8 32 5 10.6 39 4 8.4 Candler 10,432 7 67.1 7 3 28.8 29 0 0.0 100 0 0.0 84 0 0.0 Carroll 111,928 30 26.8 83 18 16.1 83 14 12.5 49 10 8.9 46 9 8.0 Catoosa 62,457 24 38.4 35 10 16.0 84 9 14.4 36 9 14.4 22 8 12.8 Charlton 10,592 6 56.6 14 2 18.9 60 1 9.4 67 0 0.0 84 0 0.0 Chatham 248,596 87 35.0 54 78 31.4 23 57 22.9 12 35 14.1 23 37 14.9 Chattahoochee 13,905 15 107.9 2 3 21.6 50 1 7.2 80 1 7.2 56 2 14.4 Chattooga 26,870 10 37.2 42 1 3.7 126 0 0.0 100 1 3.7 73 0 0.0 Cherokee 203,890 39 19.1 122 28 13.7 93 22 10.8 56 11 5.4 62 4 2.0 Clarke 113,457 34 30.0 69 51 45.0 9 22 19.4 20 27 23.8 6 12 10.6 Clay 3,181 0 0.0 154 1 31.4 22 1 31.4 3 0 0.0 84 0 0.0 Clayton 272,705 32 11.7 144 44 16.1 82 37 13.6 41 20 7.3 53 16 5.9 Clinch 6,964 1 14.4 139 2 28.7 30 0 0.0 100 0 0.0 84 0 0.0 Cobb 691,496 134 19.4 120 157 22.7 44 118 17.1 25 77 11.1 35 37 5.4 1 Source: Georgia Composite Medical Board, Georgia Physician Survey, 2008. Population: Governor's Office of Planning and Budget, State of Georgia. 2 Rate per 100,000 population 3 Rank ordered by rate per 100,000 population. 18 28 25 92 5 39 17 92 3 16 129 92 7 84 46 56 126 9 20 92 11 8 621 92 10 92 4 92 6 92 19 57 91 70 19 92 19 92 10 44 76 92 14 46 185 21 151 92 13 17 774 18 31 92 19 88 180 32 391 92 2 58 333 92 3 60 1,225 GEOGRAPHIC DISTRIBUTION Primary Care/Core PHYSICIANS BY SPECIALTY BY COUNTY, GEORGIA, 2008 Number, Rate and Rank County Population PRIMARY CARE (Generalists) TOTAL OB/GYN General Surgery ALL SPEC. 2008 Family Practice Internal Medicine Pediatrics # Rate2 Rank3 # Rate Rank # Rate Rank # Rate Rank # Rate Rank # Coffee 40,353 10 24.8 92 6 14.9 89 5 12.4 50 3 7.4 Colquitt 44,718 12 26.8 82 8 17.9 73 3 6.7 82 3 6.7 Columbia 108,859 28 25.7 88 20 18.4 65 10 9.2 69 5 4.6 Cook 16,401 8 48.8 19 2 12.2 96 0 0.0 100 1 6.1 Coweta 118,964 16 13.4 140 18 15.1 87 10 8.4 72 5 4.2 Crawford 12,540 2 15.9 130 0 0.0 128 0 0.0 100 0 0.0 Crisp 22,179 6 27.1 81 7 31.6 21 5 22.5 13 4 18.0 Dade 16,195 7 43.2 26 3 18.5 64 3 18.5 22 0 0.0 Dawson 21,602 9 41.7 28 1 4.6 125 3 13.9 39 0 0.0 Decatur 28,543 10 35.0 53 4 14.0 92 3 10.5 57 3 10.5 DeKalb 733,746 190 25.9 87 277 37.8 16 235 32.0 2 78 10.6 Dodge 19,772 9 45.5 24 6 30.3 24 5 25.3 7 3 15.2 Dooly 11,536 6 52.0 18 2 17.3 78 0 0.0 100 0 0.0 Dougherty 95,301 26 27.3 79 40 42.0 11 21 22.0 15 24 25.2 Douglas 124,324 20 16.1 129 22 17.7 75 23 18.5 23 9 7.2 Early 11,807 4 33.9 57 2 16.9 79 0 0.0 100 0 0.0 Echols 4,155 1 24.1 97 0 0.0 128 0 0.0 100 0 0.0 Effingham 50,838 10 19.7 118 5 9.8 103 0 0.0 100 1 2.0 Elbert 20,613 7 34.0 56 5 24.3 40 0 0.0 100 0 0.0 Emanuel 22,554 7 31.0 64 2 8.9 109 1 4.4 89 2 8.9 Evans 11,395 4 35.1 51 2 17.6 76 0 0.0 100 2 17.6 Fannin 22,555 15 66.5 9 3 13.3 94 2 8.9 70 1 4.4 Fayette 105,933 32 30.2 67 40 37.8 15 23 21.7 16 22 20.8 Floyd 95,117 62 65.2 12 39 41.0 12 14 14.7 33 13 13.7 Forsyth 158,369 43 27.2 80 29 18.3 67 23 14.5 35 3 1.9 Franklin 21,833 9 41.2 29 2 9.2 107 1 4.6 88 2 9.2 Fulton 990,790 224 22.6 104 554 55.9 2 290 29.3 4 235 23.7 Gilmer 28,578 11 38.5 34 6 21.0 53 2 7.0 81 0 0.0 Glascock 2,769 1 36.1 47 0 0.0 128 0 0.0 100 0 0.0 Glynn 74,753 29 38.8 33 14 18.7 62 14 18.7 21 14 18.7 Gordon 52,005 19 36.5 45 11 21.2 52 5 9.6 64 5 9.6 Grady 24,911 8 32.1 60 5 20.1 55 0 0.0 100 0 0.0 Greene 15,736 7 44.5 25 4 25.4 34 2 12.7 45 4 25.4 1 Source: Georgia Composite Medical Board, Georgia Physician Survey, 2008. Population: Governor's Office of Planning and Budget, State of Georgia. 2 Rate per 100,000 population 3 Rank ordered by rate per 100,000 population. 52 4 9.9 57 3 6.7 67 1 0.9 60 0 0.0 71 8 6.7 84 0 0.0 15 3 13.5 84 0 0.0 84 0 0.0 40 2 7.0 37 59 8.0 21 1 5.1 84 0 0.0 5 16 16.8 55 5 4.0 84 0 0.0 84 0 0.0 78 2 3.9 84 1 4.9 47 1 4.4 16 1 8.8 68 1 4.4 10 11 10.4 24 7 7.4 79 5 3.2 45 0 0.0 7 138 13.9 84 1 3.5 84 0 0.0 14 9 12.0 43 2 3.8 84 2 8.0 3 3 19.1 19 34 65 55 63 91 142 92 15 54 115 92 2 20 38 92 17 92 17 52 47 45 2,334 61 32 92 8 10 295 71 142 92 6 92 1 73 28 63 16 68 25 42 13 69 36 33 216 50 313 81 197 92 19 19 3,846 77 29 92 1 24 213 74 63 47 16 6 26 GEOGRAPHIC DISTRIBUTION Primary Care/Core PHYSICIANS BY SPECIALTY BY COUNTY, GEORGIA, 2008 Number, Rate and Rank County Population PRIMARY CARE (Generalists) TOTAL OB/GYN General Surgery ALL SPEC. 2008 Family Practice Internal Medicine Pediatrics # Rate2 Rank3 # Rate Rank # Rate Rank # Rate Rank # Rate Rank # Gwinnett 772,464 146 18.9 124 138 17.9 74 138 17.9 24 61 7.9 50 24 3.1 82 962 Habersham 42,164 7 16.6 127 9 21.3 51 4 9.5 66 2 4.7 66 4 9.5 38 40 Hall 178,838 39 21.8 108 54 30.2 25 25 14.0 38 19 10.6 38 16 8.9 41 374 Hancock 9,623 3 31.2 62 1 10.4 101 0 0.0 100 0 0.0 84 0 0.0 92 5 Haralson 28,708 7 24.4 94 3 10.5 100 1 3.5 95 0 0.0 84 1 3.5 78 15 Harris 29,112 2 6.9 152 2 6.9 118 0 0.0 100 1 3.4 75 0 0.0 92 13 Hart 24,123 6 24.9 91 7 29.0 27 0 0.0 100 0 0.0 84 3 12.4 23 22 Heard 11,424 1 8.8 150 0 0.0 128 0 0.0 100 0 0.0 84 0 0.0 92 1 Henry 184,902 44 23.8 98 18 9.7 105 21 11.4 53 16 8.7 48 6 3.2 79 210 Houston 131,291 31 23.6 99 33 25.1 38 17 12.9 43 14 10.7 36 6 4.6 67 210 Irwin 9,967 1 10.0 149 1 10.0 102 1 10.0 59 1 10.0 42 0 0.0 92 4 Jackson 59,727 11 18.4 125 3 5.0 122 3 5.0 87 1 1.7 80 1 1.7 89 25 Jasper 13,660 4 29.3 72 6 43.9 10 2 14.6 34 0 0.0 84 1 7.3 51 16 Jeff Davis 13,237 3 22.7 102 3 22.7 45 0 0.0 100 0 0.0 84 2 15.1 15 11 Jefferson 16,385 5 30.5 66 3 18.3 68 2 12.2 51 0 0.0 84 0 0.0 92 18 Jenkins 8,542 2 23.4 100 1 11.7 98 0 0.0 100 0 0.0 84 0 0.0 92 3 Johnson 9,414 2 21.2 111 3 31.9 20 0 0.0 100 0 0.0 84 0 0.0 92 6 Jones 27,279 4 14.7 136 0 0.0 128 0 0.0 100 0 0.0 84 0 0.0 92 6 Lamar 16,930 6 35.4 50 0 0.0 128 0 0.0 100 2 11.8 32 0 0.0 92 8 Lanier 8,015 3 37.4 39 1 12.5 95 0 0.0 100 0 0.0 84 0 0.0 92 5 Laurens 47,480 17 35.8 49 23 48.4 6 6 12.6 48 8 16.8 17 6 12.6 22 120 Lee 33,028 5 15.1 133 1 3.0 127 1 3.0 96 0 0.0 84 0 0.0 92 15 Liberty 60,542 8 13.2 142 11 18.2 70 13 21.5 17 5 8.3 49 3 5.0 62 71 Lincoln 8,031 3 37.4 41 0 0.0 128 0 0.0 100 0 0.0 84 0 0.0 92 3 Long 11,238 0 0.0 154 1 8.9 108 0 0.0 100 0 0.0 84 0 0.0 92 2 Lowndes 101,715 23 22.6 103 21 20.6 54 8 7.9 75 12 11.8 33 12 11.8 25 180 Lumpkin 26,607 7 26.3 86 2 7.5 114 1 3.8 93 2 7.5 51 3 11.3 27 29 Macon 13,354 5 37.4 38 2 15.0 88 1 7.5 77 0 0.0 84 1 7.5 49 15 Madison 27,780 4 14.4 138 2 7.2 116 3 10.8 55 0 0.0 84 0 0.0 92 12 Marion 7,048 3 42.6 27 0 0.0 128 0 0.0 100 0 0.0 84 0 0.0 92 5 McDuffie 21,526 8 37.2 43 4 18.6 63 2 9.3 68 0 0.0 84 1 4.6 66 20 McIntosh 11,453 2 17.5 126 0 0.0 128 0 0.0 100 0 0.0 84 0 0.0 92 3 Meriwether 22,788 7 30.7 65 5 21.9 49 1 4.4 90 1 4.4 69 0 0.0 92 22 1 Source: Georgia Composite Medical Board, Georgia Physician Survey, 2008. Population: Governor's Office of Planning and Budget, State of Georgia. 2 Rate per 100,000 population 3 Rank ordered by rate per 100,000 population. 20 GEOGRAPHIC DISTRIBUTION Primary Care/Core PHYSICIANS BY SPECIALTY BY COUNTY, GEORGIA, 2008 Number, Rate and Rank NUMBER OF PHYSICIANS BY SPECIALTY 1 County Population PRIMARY CARE (Generalists) TOTAL OB/GYN General Surgery ALL SPEC. 2008 Family Practice Internal Medicine Pediatrics # Rate2 Rank3 # Rate Rank # Rate Rank # Rate Rank # Rate Rank # Miller 6,164 6 97.3 3 1 16.2 81 1 16.2 29 0 0.0 84 1 16.2 Mitchell 24,086 9 37.4 40 2 8.3 111 2 8.3 74 1 4.2 72 0 0.0 Monroe 25,069 5 19.9 115 2 8.0 112 1 4.0 92 0 0.0 84 0 0.0 Montgomery 8,986 1 11.1 146 1 11.1 99 0 0.0 100 0 0.0 84 0 0.0 Morgan 18,185 3 16.5 128 3 16.5 80 0 0.0 100 0 0.0 84 1 5.5 Murray 40,729 6 14.7 135 4 9.8 104 1 2.5 97 1 2.5 77 1 2.5 Muscogee 186,613 114 61.1 13 42 22.5 47 31 16.6 28 23 12.3 30 22 11.8 Newton 95,739 7 7.3 151 18 18.8 61 8 8.4 73 3 3.1 76 2 2.1 Oconee 31,511 7 22.2 106 5 15.9 85 4 12.7 46 0 0.0 84 1 3.2 Oglethorpe 13,962 4 28.6 75 0 0.0 128 0 0.0 100 0 0.0 84 0 0.0 Paulding 127,903 13 10.2 148 6 4.7 124 2 1.6 99 1 0.8 83 2 1.6 Peach 26,184 5 19.1 123 2 7.6 113 0 0.0 100 0 0.0 84 1 3.8 Pickens 30,406 8 26.3 85 6 19.7 58 0 0.0 100 2 6.6 59 5 16.4 Pierce 17,851 5 28.0 77 0 0.0 128 0 0.0 100 0 0.0 84 0 0.0 Pike 17,193 2 11.6 145 0 0.0 128 2 11.6 52 0 0.0 84 0 0.0 Polk 41,447 19 45.8 23 2 4.8 123 1 2.4 98 0 0.0 84 1 2.4 Pulaski 9,803 4 40.8 30 5 51.0 4 1 10.2 58 4 40.8 1 0 0.0 Putnam 20,264 6 29.6 71 4 19.7 57 2 9.9 61 1 4.9 64 0 0.0 Quitman 2,649 0 0.0 154 0 0.0 128 0 0.0 100 0 0.0 84 0 0.0 Rabun 16,564 8 48.3 20 3 18.1 71 0 0.0 100 0 0.0 84 3 18.1 Randolph 7,284 5 68.6 5 0 0.0 128 0 0.0 100 0 0.0 84 2 27.5 Richmond 197,322 106 53.7 16 118 59.8 1 88 44.6 1 62 31.4 2 53 26.9 Rockdale 81,835 21 25.7 89 33 40.3 13 13 15.9 30 11 13.4 26 7 8.6 Schley 4,125 1 24.2 95 0 0.0 128 0 0.0 100 0 0.0 84 0 0.0 Screven 15,047 2 13.3 141 1 6.6 119 0 0.0 100 0 0.0 84 0 0.0 Seminole 9,012 2 22.2 107 2 22.2 48 2 22.2 14 2 22.2 9 2 22.2 Spalding 63,056 10 15.9 131 16 25.4 36 8 12.7 47 8 12.7 29 6 9.5 Stephens 25,214 5 19.8 117 6 23.8 41 6 23.8 11 4 15.9 19 4 15.9 Stewart 4,589 4 87.2 4 0 0.0 128 0 0.0 100 0 0.0 84 0 0.0 Sumter 32,560 7 21.5 110 9 27.6 33 5 15.4 31 4 12.3 31 3 9.2 Talbot 6,568 1 15.2 132 1 15.2 86 0 0.0 100 0 0.0 84 0 0.0 Taliaferro 1,848 2 108.2 1 0 0.0 128 0 0.0 100 0 0.0 84 0 0.0 Tattnall 22,976 15 65.3 11 4 17.4 77 0 0.0 100 0 0.0 84 0 0.0 1 Source: Georgia Composite Medical Board, Georgia Physician Survey, 2008. Population: Governor's Office of Planning and Budget, State of Georgia. 2 Rate per 100,000 population 3 Rank ordered by rate per 100,000 population. 21 12 9 92 17 92 9 92 3 59 9 85 17 26 513 87 81 80 30 92 4 90 35 75 13 11 40 92 5 92 4 86 32 92 22 92 16 92 0 7 27 1 8 2 1,260 43 156 92 1 92 4 3 11 36 94 13 41 92 4 40 45 92 2 92 2 92 19 GEOGRAPHIC DISTRIBUTION Primary Care/Core PHYSICIANS BY SPECIALTY BY COUNTY, GEORGIA, 2008 Number, Rate and Rank NUMBER OF PHYSICIANS BY SPECIALTY 1 County Population PRIMARY CARE (Generalists) TOTAL OB/GYN General Surgery ALL SPEC. 2008 Family Practice Internal Medicine Pediatrics # Rate2 Rank3 # Rate Rank # Rate Rank # Rate Rank # Rate Rank # 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 8,655 2 23.1 101 0 0.0 128 0 0.0 100 0 0.0 84 13,298 5 37.6 36 4 30.1 26 0 0.0 100 0 0.0 84 10,258 2 19.5 119 0 0.0 128 1 9.7 63 0 0.0 84 45,301 21 46.4 22 16 35.3 17 12 26.5 5 6 13.2 27 42,152 12 28.5 76 14 33.2 18 11 26.1 6 8 19.0 12 27,767 7 25.2 90 9 32.4 19 7 25.2 8 7 25.2 4 10,849 6 55.3 15 3 27.7 32 0 0.0 100 0 0.0 84 6,905 1 14.5 137 0 0.0 128 0 0.0 100 0 0.0 84 63,398 7 11.0 147 16 25.2 37 7 11.0 54 10 15.8 20 9,380 3 32.0 61 0 0.0 128 0 0.0 100 0 0.0 84 10,218 0 0.0 154 0 0.0 128 0 0.0 100 0 0.0 84 20,894 11 52.6 17 2 9.6 106 2 9.6 65 2 9.6 44 27,547 8 29.0 74 4 14.5 90 1 3.6 94 2 7.3 54 64,558 18 27.9 78 0 0.0 128 0 0.0 100 1 1.5 81 83,241 18 21.6 109 10 12.0 97 6 7.2 79 3 3.6 74 35,931 13 36.2 46 17 47.3 7 7 19.5 18 6 16.7 18 5,865 4 68.2 6 0 0.0 128 0 0.0 100 0 0.0 84 20,853 4 19.2 121 6 28.8 28 5 24.0 10 1 4.8 65 28,996 9 31.0 63 2 6.9 117 4 13.8 40 3 10.3 41 2,266 0 0.0 154 0 0.0 128 0 0.0 100 0 0.0 84 6,783 1 14.7 134 0 0.0 128 0 0.0 100 0 0.0 84 24,873 6 24.1 96 0 0.0 128 0 0.0 100 0 0.0 84 92,707 28 30.2 68 23 24.8 39 18 19.4 19 18 19.4 11 8,668 0 0.0 154 0 0.0 128 0 0.0 100 0 0.0 84 10,241 4 39.1 31 2 19.5 59 1 9.8 62 0 0.0 84 10,031 3 29.9 70 0 0.0 128 0 0.0 100 0 0.0 84 21,315 8 37.5 37 3 14.1 91 3 14.1 37 0 0.0 84 9,533,761 2,524 2,500 1,583 1,041 0 0.0 1 7.5 0 0.0 7 15.5 4 9.5 3 10.8 0 0.0 0 0.0 7 11.0 0 0.0 0 0.0 1 4.8 3 10.9 2 3.1 3 3.6 7 19.5 0 0.0 4 19.2 2 6.9 0 0.0 0 0.0 1 4.0 9 9.7 0 0.0 0 0.0 0 0.0 1 4.7 730 92 3 48 10 92 3 14 160 37 102 31 57 92 15 92 1 29 109 92 4 92 1 64 34 30 39 83 40 76 59 4 132 92 4 5 25 53 33 92 0 92 1 72 10 35 202 92 0 92 14 92 4 65 19 19,046 1 Source: Georgia Composite Medical Board, Georgia Physician Survey, 2008. Population: Governor's Office of Planning and Budget, State of Georgia. 2 Rate per 100,000 population 3 Rank ordered by rate per 100,000 population. 22 Metropolitan and Non-Metropolitan Statistical Areas in Georgia DADE CATOOSA WHITFIELD WALKER MURRAY CHATTOOGA GORDON FANNIN TOWNS UNION RABUN GILMER PICKENS HABER- WHITE SHAM LUMPKIN STEPHENS DAWSON FRANKLIN HALL BANKS HART FLOYD CHEROKEE FORSYTH BARTOW JACKSON ELBERT MADISON POLK PAULDING COBB HARALSON GWINNETT BARROW WALTON CLARKE OCONEE OGLETHORPE WILKES LINCOLN DEKALB ROCKDALE DOUGLAS FULTON 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- WHEELER ERY TOOMBS EVANS 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 U.S. Census Bureau as of November, 2004 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 medicine, 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 medicine, internal medicine, pediatrics, and OB/GYN. 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 medicine, internal medicine, pediatrics, and OB/GYN. 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 20% 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 medicine, 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 Joe Sam Robinson, Jr., M.D. Chairman James R. Lowry Vice Chairman Gilbert S. Klemann, M.D. - Secretary/Treasurer Crystal L. Brown, M.D. Brian K. Burdette Frank L. Carter, M.D. Jacinto del Mazo, M.D. E. Daniel DeLoach, M.D. Paul Fischer, M.D. Thomas L. Hatchett, Jr., M.D. William H. Lee, III James G. Peak William C. Waters, IV, M.D. Cherri Tucker, Executive Director for the Georgia Board for Physician Workforce BOARD STAFF Colette Caldwell, Carla Graves, Olive Jones-Golden, and Pamela Smith 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 Georgia Composite Medical Board (GCMB), and to the GCMB staff for their support of these efforts. Two Peachtree St., N.W., 36th Floor, Atlanta, GA 30303, www.gbpw.georgia.gov