| This study analyzed physician migration in non-metropolitan counties of the 48 U.S. contiguous states during a four-year period. This research has studied the major social economic attributes of rural counties that experienced physician migration, and major characteristics of migrant physicians. OLS models and multinomial models have been used to explore the relationship between physician migration and selected factors at the aggregate level and individual level as well. Empirical findings have provided answers to who moved, where they moved, and the impacts of such moves.;During the same period, 22,996 physicians moved into 2,011 rural counties. These physicians originated from other rural counties (33.9%), urban counties (58.2%), and training institutions (7.8%).;The loss-gain ratio, a ratio derived from physician net migration, indicates that 56 physicians move out for every 100 physicians that entered rural counties during the period. The finding seems to support the standard location theory that more physicians would be trickled down to more rural areas as the increases of physician supply nationwide. Yet, only those rural counties with large population have had positive net physician migration; other rural counties have actually lost some of their physicians.;Findings from physician migration models at the county level show that the health system factor is more important to physician out-migration than other selected factors, such as location, soci-economic, and policy. On the other hand, the location factor is far more important to physician in-migration and net migration. A major finding from the multinomial model is that physicians with previous working experience in HPSA designated counties are more likely to re-locate into another HPSA designated county after these doctors move out of rural counties.;From 1987 to 1990, 15,811 active physicians moved out of 1,944 non-metropolitan counties. These physicians practiced in 80 AMA-defined specialties. After they moved, these physicians relocated in 2,190 counties, either metropolitan counties (30.4%), or non-metropolitan counties (69.6%).;The study concludes that physician migration is a very dynamic process in non-metropolitan counties. Physician migration may have significant impacts on physician work force availability and stability in rural counties. This may have effects on the continuity of care in these areas. |
