title: Rural-urban distribution of the U.S. Geriatrics physician workforce.
abstract: OBJECTIVE
  To determine the distribution of geriatricians across the rural-urban continuum from 2000 to 2008 and to compare with primary care physicians in 2008.
  
  
  METHODS
  County-level analysis of physician data from the American Medical Association Physician Masterfile for 2000, 2004, and 2008 merged with U.S. Census data on the number of older (≥65) county residents. Descriptive statistics for each year were stratified according to 2003 Rural Urban Continuum Codes (RUCCs).
  
  
  METHODS
  United States.
  
  
  METHODS
  Physicians in the United States.
  
  
  METHODS
  Number of physicians per county elderly population.
  
  
  RESULTS
  The number of self-identified geriatricians nationwide increased from 5,157 to 7,412 from 2000 to 2008. The number of geriatricians increased in each RUCC level, with nearly 90% of geriatricians residing in urban areas in all years. In 2008, the number of geriatricians per 10,000 older adults declined as rurality increased (from 1.48 in the most-urban areas to 0.80 in the most rural). General internal medicine physicians are more plentiful in urban counties and declined as rurality increased (from 27.29 to 3.85 per 10,000 older adults in 2008). In contrast, family physicians were more evenly distributed with the elderly population across the rural-urban continuum (22.02 to 14.27 per 10,000 older adults in 2008).
  
  
  CONCLUSIONS
  Small numbers of geriatricians combined with a growing elderly population poses a challenge and an opportunity. Healthcare systems and policy-makers will need to modify care models to better use the skill of geriatricians in concert with other providers to provide quality care for older rural and urban Americans.
authors: Department of Family Medicine, Medical University of South Carolina, Charleston, South Carolina, USA. petla@musc.edu
authors: Lars E
authors: LE
authors: Peterson
authors: Andrew
authors: A
authors: Bazemore
authors: Elizabeth J
authors: EJ
authors: Bragg
authors: Imam
authors: I
authors: Xierali
authors: Gregg A
authors: GA
authors: Warshaw
mesh_terms: D000368:Aged; D005853:Geriatrics; D006801:Humans; D008507:Medically Underserved Area; D010820:Physicians / Q000600:supply & distribution*; D012189:Retrospective Studies; D019035:Rural Health Services; D012424:Rural Population / Q000706:statistics & numerical data*; D014481:United States; D014505:Urban Population / Q000706:statistics & numerical data*; D000078329:Workforce