Sosrh 2008 Edition

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Sosrh 2008 Edition

  1. 1. 2008 Edition State of the State’s Rural Health Workforce Issues: Physicians & Hospitals
  2. 2. On the Cover: 2007 honors The the Cover: for Rural Health was honored in 2007 for its leadership and contributions to rural health. William Pettit, D.O., OSU Center for On OSU Center Health Sciences associate dean and assistant professor for rural health, is shown here with a BlueCross BlueShield of Oklahoma - Champions of 2007 honors Health award and the Rural Health Association of Oklahoma’s Rural Organization of the Year for 2007 plaque. (Photo by Terry Drenner) The OSU Center for Rural Health was honored in 2007 for its leadership and contributions to rural health. William Pettit, D.O., OSU Center for Health Sciences associate dean and assistant professor for rural health, is shown with a BlueCross BlueShield of Oklahoma - Champions of Health award and the Rural Health Association of Oklahoma’s Rural Organization of the Year for 2007 plaque. (Photo by Terry Drenner)
  3. 3. Preface Welcome to the Oklahoma State University Center for Rural Health’s second edition of the State of the State’s Rural Health. The theme for this year’s publication is “Workforce Issues: Physicians Hospitals.” Oklahoma, like the rest of the nation, is facing a critical shortage of physicians, particularly among the various primary care specialties. Some data indicate that Oklahoma is already suffering a physician shortage. In 2007, the American Medical Association reported that Oklahoma ranked last in the nation with the fewest number of patient care and primary care physicians per 00,000 population. This dearth of physicians led, in part, to the United Health Foundation ranking Oklahoma 47th in overall health status. On a more ominous note, the Commonwealth Fund ranked Oklahoma 50th in health system performance. While the causes of the physician shortage are many, the solution to the problem is simple: Oklahoma needs more physicians, especially in rural areas, and physicians with primary care specialties. How to increase the physician supply is debatable. The OSU Center for Health Sciences is committed to guiding more primary care physicians to rural Oklahoma through increasing its medical school class sizes, expanding graduate medical education programs into rural areas, and fostering a rural pipeline to return physicians back to the communities where they were raised. This publication outlines the characteristics of Oklahoma’s rural physician workforce. Evident is the maldistribution of physicians between urban and rural portions of the state and an aging physician workforce. This edition also provides an overview of medical education in the state and the characteristics of the state’s hospital infrastructure. More physicians alone cannot improve Oklahoma’s health status. Oklahomans must be willing to make social and behavioral changes like those outlined in Governor Brad Henry’s “Strong and Healthy Oklahoma” initiative if we want to have a truly healthy state. For more information about Oklahoma’s rural health, please visit our web site: http://ruralhealth.okstate.edu/ Chad Landgraf, M.S. Jeff Hackler, J.D., M.B.A. Tulsa, Oklahoma
  4. 4. Defining Rural Oklahoma R ural means different things to different people. of their population living in urban coded tracts were No single definition of rural exists. The federal classified as Mixed, and counties with less than 65 government commonly uses four different percent of their population living in urban coded tracts definitions of rural just within its various health were classified as Rural. programs. The OSU Center for Rural Health uses The development of these three categories (Rural, the definition that is most widely accepted among Urban, and Mixed) allowed us to compare the health those who conduct rural health research: the Rural- and socioeconomic data of a county versus its place Urban Commuting Area codes developed by the along the urban-rural continuum. Washington, Wyoming, Alaska, Montana, and Idaho Rural Health Research Center housed at the University The table at the right shows selected socioeconomic of Washington School of Medicine in Seattle. and demographic characteristics of Rural, Urban, and Mixed Oklahoma. These characteristics are often Most publicly accessible health and demographic data cited as macro-level determinants of health status for are compiled at the county-level, while RUCA codes a population. For example, lower levels of educational provide detail down to the spatially smaller census attainment are directly related to lower incomes, tract-level. For each county in the state, we calculated which in turn generally lead to lower overall health the total percentage of the population living in census status. A county-by-county breakdown of these data tracts designated with urban and rural RUCA codes. is presented in a table on the next two pages, followed Counties with more than 95 percent of their population by two maps that show the distribution of population living in urban coded tracts were classified as Urban, among the counties and county-level population counties with between 95 percent and 65 percent change between 990 and 2000. 2
  5. 5. Designation of Counties as Urban, Rural, or Mixed Based on Rural-Urban Commuting Area Codes CIMARRON TEXAS OTTAWA BEAVER HARPER WOODS WASHINGTON ALFALFA GRANT KAY CRAIG NOWATA OSAGE WOODWARD ELLIS GARFIELD NOBLE DELAWARE ROGERS County Designation MAJOR PAWNEE MAYES Rural (68) PAYNE TULSA DEWEY KINGFISHER WAGONER Mixed Urban Rural (5) BLAINE LOGAN CREEK CHEROKEE ADAIR Urban (4) ROGER MILLS LINCOLN CUSTER OKMULGEE MUSKOGEE Source: Adapted from WWAMI Rural Health Research Center (2006) CANADIAN OKLAHOMA OKFUSKEE SEQUOYAH BECKHAM McINTOSH POTTAWATOMIE WASHITA C CL SEMINOLE EV CADDO HASKELL V EL AN M Mc D D GRADY HUGHES Mixed C CL GREER KIOWA AIIN PITTSBURG Le FLORE 304,803 LATIMER 8.5% HARMON PONTOTOC COMANCHE GARVIN JACKSON COAL STEPHENS TILLMAN MURRAY PUSHMATAHA Rural COTTON JOHNSTON ATOKA Urban 1,667,573 CARTER JEFFERSON McCURTAIN 1,606,836 46.6% MARSHALL CHOCTAW 44.9% LOVE BRYAN Population by Rural, Urban, or Mixed Selected Socioeconomic Demographic Comparison of Rural, Urban, and Mixed Counties in Oklahoma Rural Urban Mixed Oklahoma White 76% 7% 82% 74% Black 4% 2% % 7% Native American % 4% 6% 8% Hispanic 4% 7% % 5% Other 5% 6% 6% 6% Avg. Median Age 8.2 years 2.7 years 6. years 7.8 years % Population Living in Poverty 7% % 0% 5% Avg. Median Household Income $28,856 $7,247 $8,882 $29,94 % of Population Over Age 65 5% % % % % Adult Population without High School 2% 6% 8% 9% Degree or G.E.D. Source: U.S. Census Bureau (2000)
  6. 6. Native Median Pop. in Med. HH No H.S. White Black Hisp. Other Age 65+ County American Age Poverty Income Diploma (%) (%) (%) (%) (%) (%) (yrs) (%) ($) (%) Adair 47.7 0.2 4.8 . 7.2 .2 22.7 24,88 2.0 . Alfalfa 88.4 4. 2.6 2.9 2. 42. . 0,259 20.4 8.6 Atoka 75.4 5.9 .2 .4 6. 8. 7.5 24,752 4.8 0.6 Beaver 86.6 0. .2 0.8 .2 9. .5 6,75 6.9 8.8 Beckham 84.7 5. 2.4 5.4 2. 6.6 6.4 27,402 5.5 24. Blaine 7.7 6.5 8.5 6.6 4.7 7.6 4.6 28,56 6.8 24.5 Bryan 78.9 .4 2.0 2.6 5. 5.8 7.9 27,888 5.4 25. Caddo 64. 2.9 2.0 6. .8 6.0 20.8 27,47 4.9 24. Canadian 85.0 2. 4. .9 4.9 5.4 7.7 45,49 9.5 2.7 Carter 76.8 7.5 8. 2.8 4.8 8.0 6.2 29,405 6.0 2.0 Cherokee 55.2 .2 .9 4. 7.5 2. 22.0 26,56 2.0 2. Choctaw 67.8 0.9 4.8 .6 4.9 8.7 2.9 22,74 7.4 .0 Cimarron 8.0 0.5 .0 5.4 2.0 9. 7. 0,625 8.6 2.4 Cleveland 8.5 .5 4.2 4.0 6.7 2.2 0. 4,846 8.4 .9 Coal 74.5 0.4 7.0 2. 6.0 8. 22.6 2,705 7.9 .4 Comanche 62.0 8.6 4.8 8.4 6.2 0. 4.2 ,867 9.8 4.8 Cotton 82.8 2.8 6.8 4.9 2.7 8.6 7.6 27,20 7.8 2.0 Craig 68. . 6.2 .2 .5 9. 2.8 0,997 6.2 2. Creek 8.4 2.5 8.9 .9 5.2 6.9 .2 ,68 2.8 22.4 Custer 79. 2.8 5.5 9.0 . 2.7 7.6 28,524 .7 8.8 Delaware 69.4 0. 22. .8 6.6 40.8 8.0 27,996 7.5 24.6 Dewey 90.6 0. 4.5 2.7 2.0 4.0 4.5 28,72 2.0 20.2 Ellis 94.8 0.0 . 2.6 .4 45. 2. 27,95 22.0 8.8 Garfield 86.9 .2 2.0 4. .7 7.7 .5 ,006 6.0 7.8 Garvin 8.4 2.5 7.2 .4 .4 9.0 5.7 28,070 7.9 27.0 Grady 86. .0 4.7 2.9 . 6.5 .6 2,625 . 20.5 Grant 94. 0. 2.4 .8 .4 4.4 .4 28,977 2.4 4. Greer 78.7 8.7 2.4 7.4 2.8 40.0 6.4 25,79 20.0 2. Harmon 65.8 9.2 .0 22.8 .2 9.9 28.6 22,65 2.0 6.8 Harper 92.9 0.0 0.9 5.6 0.5 4. 0.0 ,705 2.7 7.9 Haskell 77.5 0.6 4.5 .5 5.9 8.6 20.2 24,55 7.2 . Hughes 7.8 4.5 5.8 2.5 5.4 9. 9.9 22,62 8.6 29.2 Jackson 7.5 7.9 .6 5.6 .4 .0 5.7 0,77 .9 20.9 Jefferson 8.7 0.6 5.0 7.0 .7 40.4 8.2 2,647 20. 0.7 Johnston 75.4 .7 4.9 2.5 5.6 8.0 2.4 24,592 5.4 0.9 Kay 82.5 .8 7. 4. 4. 8. 5.7 0,762 7.0 9. Kingfisher 86. .5 .0 6.9 2.5 8.0 0.6 6,676 5.4 8.8 Kiowa 80.5 4.6 5.9 6.7 2. 40.9 8.6 26,05 20. 22.6 Latimer 72.5 0.9 9.2 .5 5.9 6.8 2. 2,962 6. 26.2 4
  7. 7. Native Median Pop. in Med. HH No H.S. White Black Hisp. Other Age 65+ County American Age Poverty Income Diploma (%) (%) (%) (%) (%) (%) (yrs) (%) ($) (%) Le Flore 78.4 2.2 0.6 .8 5.0 6. 8.4 27,278 .8 29.6 Lincoln 85.7 2.4 6.4 .5 .9 7.5 4. ,87 .9 22.5 Logan 80. 0.9 2.8 2.9 . 6. 2. 6,784 2. 8.5 Love 8. 2.2 6.4 7.0 .2 9.4 .7 2,558 6.2 26.4 Major 9.8 0.2 0.9 4.0 .2 4.6 .8 0,949 9.4 2.4 Marshall 76.5 .8 8.7 8.6 4.4 4. 7.5 26,47 9.5 29.0 Mayes 7. 0. 8.9 .9 7.6 7.2 4.0 ,25 4.9 2.9 McClain 85. 0.6 5.4 4.9 .7 6.9 0.4 7,275 2.0 20.7 McCurtain 69.5 9.2 .2 . 5.0 6.0 24. 24,62 4.0 0.8 McIntosh 72.0 4.0 6. . 6.7 44. 7.8 25,964 2.8 28.4 Murray 79.2 .9 .4 . 4.4 9.8 .7 0,294 8.5 25.7 Muskogee 62.8 . 4.7 2.7 6.8 7.0 7. 28,48 5. 24.9 Noble 85.8 .6 7.4 .8 .4 8. 2.5 ,968 5.2 8.5 Nowata 7.9 2.5 6. .2 8. 9.0 .8 29,470 7. 2.8 Okfuskee 64.9 0.4 7.9 .6 5.2 8.6 2.2 24,24 6. 0.6 Oklahoma 67. 4.9 .2 8.7 6. 4.2 4.9 5,06 2.2 7.5 Okmulgee 69.0 0.2 2.6 .9 6. 6.9 8.4 27,625 5. 25. Osage 66. 0.7 4.2 2. 6.9 8. 2.7 4,477 . 9.8 Ottawa 72.9 0.6 6.4 .2 7.0 7. 6. 27,507 6.9 24. Pawnee 8.7 0.7 2.0 .2 4.5 8.5 2.9 ,66 4.8 2.2 Payne 8. .6 4.5 2. 6.5 27.6 8.2 28,7 0.8 . Pittsburg 76. 4.0 2. 2. 5. 9.4 6.0 28,679 7. 2.8 Pontotoc 74.8 2.0 5.2 2. 5.6 5.7 5.9 26,955 5.0 2.8 Pottawatomie 78.8 2.9 0.9 2.4 5. 5.5 .9 ,57 .8 20.7 Pushmataha 77. 0.7 5.4 .6 5. 40. 22.6 22,27 8. .0 Roger Mills 90.2 0. 5.2 2.6 .6 4.7 6. 0,078 8.7 20.7 Rogers 79.0 0.7 .9 .8 6.6 6.2 8.5 44,47 . 6.6 Seminole 69.9 5.5 7. 2.2 5. 8. 20. 25,568 6.7 26.8 Sequoyah 67.4 .8 9.4 2.0 9. 6.4 9.5 27,65 .5 29.8 Stephens 96.2 2.2 4.8 4.0 2.9 40. 4. 0,709 8.5 2.0 Texas 66.7 0.6 0.9 29.9 .9 0.4 .8 5,872 0.2 28. Tillman 68.5 8.9 2.5 7.7 2.4 8.9 2.0 24,828 9. 2.6 Tulsa 72.5 0.8 5. 6.0 5.7 4.4 .4 8,2 .8 4.9 Wagoner 78.9 .7 9.2 2.5 5.7 6.2 8.8 4,744 0.2 8.7 Washington 79.9 2.5 8.5 2.6 6.5 40. .7 5,86 7.8 4.8 Washita 90.4 0.4 2.8 4.5 .9 9.2 5. 29,56 8.8 20. Woods 9.9 2. .5 2.4 .8 7.8 . 28,927 9.9 7. Woodward 90. . 2.0 4.8 .8 7.4 .9 ,58 4.2 20. Totals on Page 3 Source: U.S. Census Bureau (2000) 5
  8. 8. Total Population by County 2006 (Estimated) CIMARRON TEXAS OTTAWA BEAVER HARPER WOODS WASHINGTON ALFALFA GRANT KAY CRAIG NOWATA OSAGE WOODWARD ELLIS GARFIELD NOBLE DELAWARE ROGERS MAJOR PAWNEE MAYES Total Population TULSA PAYNE 200,001 to 691,266 DEWEY BLAINE KINGFISHER WAGONER LOGAN CREEK CHEROKEE ADAIR 100,001 to 200,000 ROGER MILLS LINCOLN 50,001 to 100,000 CUSTER OKMULGEE MUSKOGEE CANADIAN OKLAHOMA 10,001 to 50,000 OKFUSKEE SEQUOYAH 2,807 to 10,000 BECKHAM McINTOSH POTTAWATOMIE WASHITA CL SEMINOLE EV Source: U.S. Census Bureau (2006) CADDO HASKELL EL AN Mc D GRADY HUGHES CL GREER KIOWA AIN PITTSBURG Le FLORE LATIMER HARMON COMANCHE GARVIN PONTOTOC JACKSON COAL STEPHENS TILLMAN MURRAY PUSHMATAHA COTTON JOHNSTON ATOKA CARTER JEFFERSON McCURTAIN MARSHALL CHOCTAW LOVE BRYAN County-Level Population Change 1990-2000 CIMARRON TEXAS OTTAWA BEAVER HARPER WOODS WASHINGTON ALFALFA GRANT KAY CRAIG NOWATA OSAGE WOODWARD ELLIS GARFIELD NOBLE DELAWARE ROGERS MAJOR PAWNEE MAYES Percent Population Change TULSA PAYNE 1990 - 2000 DEWEY KINGFISHER WAGONER BLAINE LOGAN CREEK CHEROKEE ADAIR 20.2% to 32.1% ROGER MILLS LINCOLN 12.0% to 20.1% CUSTER OKMULGEE MUSKOGEE CANADIAN OKLAHOMA 6.4% to 11.9% OKFUSKEE SEQUOYAH 0% to 6.3% BECKHAM McINTOSH POTTAWATOMIE WASHITA CL SEMINOLE EV -7.5% to -0.1% CADDO HASKELL EL AN Mc -17.1% to -7.6% D GRADY HUGHES CL GREER KIOWA AIN PITTSBURG Le FLORE Source: U.S. Census Bureau (2000) LATIMER HARMON COMANCHE GARVIN PONTOTOC JACKSON COAL STEPHENS TILLMAN MURRAY PUSHMATAHA COTTON JOHNSTON ATOKA CARTER JEFFERSON McCURTAIN MARSHALL CHOCTAW LOVE BRYAN 6
  9. 9. Physicians
  10. 10. Oklahoma’s Physicians O klahoma is home to between 6,800 and 7,200 active (non-retired) physicians. The exact number varies depending on the data source, method of analysis, and timeliness of the data. The typical source of most physician data is the American Medical Association’s Physician Masterfile. The AMA Masterfile is a comprehensive database that is designed to catalogue information about every physician, both osteopathic (D.O.) and allopathic (M.D.), in the United States. However, our review of the Masterfile revealed some limitations, particularly among osteopathic physicians practicing in Oklahoma. To overcome these limitations, we opted to use the medical licensure databases maintained by Oklahoma’s two medical licensing boards. The data provided in this edition of the State of the State’s Rural Health assumes that 7,54 active physicians were practicing in Oklahoma during January and February of 2007. This total includes those physicians in graduate medical education programs and employed by various federal and state agencies. Of these physicians, 5,98 (7%) practice in an Urban setting, ,795 (25%) in Rural, and 6 (2%) in Mixed. Oklahoma County has the largest number of physicians with 2,565 individuals. Five counties (all Rural) have only one physician. The table on pages 2- shows a county-by-county breakdown of physicians. Osteopathic physicians account for 20% (,454) of all active physicians in the state. Most (66%) practice in Urban Oklahoma, followed by Rural (%), and Mixed (%) Oklahoma. Tulsa County is home to 605 osteopathic physicians, reflecting the presence of the state’s two leading osteopathic medical education facilities: OSU College of Osteopathic Medicine (medical education) and the OSU Medical Center (residency training). Comprising 80% of the physician workforce in the state, allopathic physicians total 5,700 active individuals. Most (74%) practice in Urban Oklahoma, followed by Rural (24%), and Mixed (2%) Oklahoma. The largest concentration of allopathic physicians is in Oklahoma County with 2,45, reflecting the presence of the state’s allopathic medical education facilities at the OU Health Sciences Center. 8
  11. 11. Active Osteopathic (D.O.) Physicians, 2007 CIMARRON TEXAS BEAVER HARPER KAY NOWATA CRAIG OTTAWA WASHINGTON ALFALFA GRANT WOODS OSAGE GARFIELD ROGERS NOBLE WOODWARD MAJOR MAYES DELAWARE Active Osteopathic Physicians ELLIS PAWNEE 1 dot represents 1 physician PAYNE TULSA DEWEY KINGFISHER WAGONER LOGAN CREEK CHEROKEE Source: Oklahoma Board of Osteopathic Examiners (01/2007) BLAINE ADAIR ROGER MILLS Mixed CUSTER OKMULGEE LINCOLN MUSKOGEE 44 CANADIAN OKLAHOMA OKFUSKEE SEQUOYAH 3% McINTOSH POTTAWATOMIE CL BECKHAM CADDO SEMINOLE WASHITA EV EL GRADY HASKELL AN Mc D GREER HUGHES PITTSBURG CL KIOWA Le FLORE AIN LATIMER Rural COMANCHE GARVIN PONTOTOC 456 HARMON COAL JACKSON 31% Urban STEPHENS MURRAY TILLMAN PUSHMATAHA 954 COTTON CARTER JOHNSTON ATOKA 66% McCURTAIN JEFFERSON CHOCTAW MARSHALL LOVE BRYAN Osteopathic Physicians by Rural, Urban, or Mixed Active Allopathic (M.D.) Physicians, 2007 CIMARRON TEXAS WOODS KAY CRAIG NOWATA OTTAWA WASHINGTON BEAVER HARPER ALFALFA GRANT OSAGE GARFIELD ELLIS NOBLE ROGERS WOODWARD MAJOR MAYES DELAWARE Active Allopathic Physicians PAWNEE 1 dot represents 1 physician PAYNE TULSA DEWEY KINGFISHER LOGAN WAGONER CHEROKEE Source: Oklahoma Board of Medical Licensure and Supervision (02/2007) BLAINE CREEK ADAIR ROGER MILLS LINCOLN CUSTER OKMULGEE CANADIAN MUSKOGEE OKLAHOMA SEQUOYAH Mixed OKFUSKEE 117 WASHITA McINTOSH POTTAWATOMIE 2% CL BECKHAM CADDO SEMINOLE EV EL GRADY HASKELL AN Mc D GREER PITTSBURG CL KIOWA HUGHES AIN Le FLORE LATIMER Rural COMANCHE GARVIN PONTOTOC HARMON 1,339 JACKSON COAL 24% STEPHENS MURRAY TILLMAN ATOKA PUSHMATAHA COTTON JOHNSTON CARTER Urban McCURTAIN 4,244 JEFFERSON CHOCTAW MARSHALL LOVE BRYAN 74% Allopathic Physicians by Rural, Urban, or Mixed 9
  12. 12. Primary Care Physicians in Oklahoma P rimary care is the most fundamental element of healthcare. Research by Starfield, Shi, and Macinko (2005) shows that access to Number of Primary Care Physicians in primary care physicians and a functioning primary Oklahoma and Neighboring States per care delivery system both result in more equitable 100,000 Population, 2005 healthcare among the population, fewer illnesses, and ultimately fewer deaths. The primary care physician is on the frontlines in battles against illness and disease. Of the 7,54 active physicians in Oklahoma, 47% Arkansas 98.7 (,2) specialize in primary care. For the purposes Colorado 116.6 of the State of the State’s Rural Health, we classified Kansas 101.6 any physician as “primary care” who had a primary specialty of family medicine/general practice, internal Missouri 106.2 medicine, pediatrics, and obstetrics/gynecology. New Mexico 113.6 Like the larger universe of physicians, most primary Oklahoma 79.7 care physicians practice in Urban Oklahoma (64%), followed by Rural (%), and Mixed (%). One county, Texas 95.5 Alfalfa, has no primary care physicians in active U.S. 119.9 practice. The table on pages 2 and shows a 0 20 40 60 80 100 120 county-by-county breakdown of the various primary Primary Care Physicians per 100,000 Population care specialties. As a state, Oklahoma ranks last in Source: American Medical Association (2007) the nation in access to primary care physicians. 0
  13. 13. Primary Care Physicians, 2007 TEXAS CIMARRON KAY NOWATA CRAIG OTTAWA WASHINGTON BEAVER HARPER ALFALFA GRANT WOODS OSAGE ROGERS NOBLE WOODWARD MAJOR MAYES Active Primary Care Physicians ELLIS GARFIELD DELAWARE PAWNEE 1 dot represents 1 physician PAYNE TULSA Source: Oklahoma Board of Osteopathic Examiners (01/2007) DEWEY WAGONER KINGFISHER LOGAN CREEK CHEROKEE Oklahoma Board of Medical Licensure Supervision (02/2007) BLAINE ADAIR ROGER MILLS CUSTER OKMULGEE LINCOLN MUSKOGEE CANADIAN OKLAHOMA OKFUSKEE SEQUOYAH McINTOSH Mixed POTTAWATOMIE CL BECKHAM WASHITA SEMINOLE EV 117 CADDO EL GRADY HASKELL AN 3% Mc D GREER HUGHES CL KIOWA PITTSBURG AIN LATIMER Le FLORE COMANCHE GARVIN PONTOTOC HARMON JACKSON COAL Rural STEPHENS MURRAY TILLMAN PUSHMATAHA 1,090 JOHNSTON COTTON CARTER ATOKA 33% Urban McCURTAIN JEFFERSON CHOCTAW 2,125 MARSHALL BRYAN LOVE 64% Primary Care Physicians by Rural, Urban, or Mixed Primary Care Physicians per 10,000 Population, 2007 CIMARRON TEXAS OTTAWA BEAVER HARPER WOODS WASHINGTON ALFALFA GRANT KAY CRAIG NOWATA OSAGE WOODWARD ELLIS GARFIELD NOBLE DELAWARE ROGERS Primary Care Physicians MAJOR PAWNEE MAYES per 10,000 Population PAYNE TULSA DEWEY 12.6 to 16.5 BLAINE KINGFISHER LOGAN CREEK WAGONER CHEROKEE ADAIR 7.6 to 12.5 ROGER MILLS LINCOLN 5.1 to 7.5 CUSTER CANADIAN OKMULGEE MUSKOGEE OKLAHOMA OKFUSKEE SEQUOYAH 3.3 to 5.0 BECKHAM McINTOSH 1.4 to 3.2 POTTAWATOMIE WASHITA CL SEMINOLE EV CADDO HASKELL No Primary Care Physicians EL AN Mc D GRADY HUGHES CL Source: Oklahoma Board of Osteopathic Examiners (01/2007) GREER KIOWA AIN PITTSBURG Le FLORE Oklahoma Board of Medical Licensure Supervision (02/2007) LATIMER HARMON COMANCHE GARVIN PONTOTOC JACKSON COAL STEPHENS TILLMAN MURRAY PUSHMATAHA COTTON JOHNSTON ATOKA CARTER JEFFERSON McCURTAIN MARSHALL CHOCTAW LOVE BRYAN
  14. 14. Total Primary Care Family Medicine/ Internal County Pediatrics OB/GYN Physicians Physicians General Practice Medicine Adair 2 9 2 0 Alfalfa 0 0 0 0 0 Atoka 4 0 0 0 Beaver 2 2 2 0 0 0 Beckham 4 8 Blaine 9 9 0 0 0 Bryan 6 4 27 9 4 Caddo 4 2 9 0 0 Canadian 64 47 5 6 Carter 92 40 7 5 5 Cherokee 67 4 8 6 6 Choctaw 7 7 6 0 0 Cimarron 4 4 4 0 0 0 Cleveland 59 57 8 6 6 22 Coal 0 0 0 Comanche 27 97 54 20 0 Cotton 0 0 0 Craig 5 7 6 0 0 Creek 42 4 2 0 Custer 27 20 5 2 0 Delaware 2 6 2 2 Dewey 0 0 0 Ellis 6 6 6 0 0 0 Garfield 25 45 2 9 6 7 Garvin 24 9 4 2 2 Grady 4 24 5 4 4 Grant 0 0 0 Greer 5 5 5 0 0 0 Harmon 2 2 2 0 0 0 Harper 0 0 0 Haskell 9 6 4 2 0 0 Hughes 2 2 2 0 0 0 Jackson 6 8 9 4 2 Jefferson 0 0 0 Johnston 5 5 4 0 0 Kay 6 0 7 7 Kingfisher 7 7 6 0 0 Kiowa 6 4 4 0 0 0 Latimer 9 6 2 0 Le Flore 8 27 9 2 2
  15. 15. Total Primary Care Family Medicine/ Internal County Pediatrics OB/GYN Physicians Physicians General Practice Medicine Lincoln 0 9 9 0 0 0 Logan 7 0 4 0 Love 4 4 4 0 0 0 Major 4 0 0 0 Marshall 7 6 5 0 0 Mayes 25 9 2 McClain 6 0 0 0 McCurtain 22 7 2 2 2 McIntosh 0 8 2 0 0 Murray 9 7 2 0 0 Muskogee 52 72 27 4 6 5 Noble 5 5 5 0 0 0 Nowata 6 6 6 0 0 0 Okfuskee 5 0 0 0 Oklahoma 2,565 95 25 2 5 25 Okmulgee 4 27 2 8 5 2 Osage 2 20 5 2 0 Ottawa 6 2 4 4 2 Pawnee 8 7 0 0 Payne 8 68 7 8 0 Pittsburg 6 28 2 9 2 5 Pontotoc 8 45 8 4 7 6 Pottawatomie 67 47 20 2 8 7 Pushmataha 7 5 5 0 0 0 Roger Mills 2 2 2 0 0 0 Rogers 8 59 6 0 5 8 Seminole 9 7 0 Sequoyah 2 6 5 0 0 Stephens 7 2 20 2 0 Texas 8 6 7 5 2 2 Tillman 5 5 5 0 0 0 Tulsa 2,057 956 82 0 68 05 Wagoner 22 5 4 0 0 Washington 9 40 24 8 4 4 Washita 2 0 0 Woods 5 2 0 0 Woodward 22 4 0 2 Totals 7,154 3,332 1,605 907 451 369 Source: Oklahoma Board of Osteopathic Examiners (01/2007); Oklahoma Board of Medical Licensure and Supervision (02/2007)
  16. 16. The Aging Physician Workforce M imicking macro demographic trends, the physician workforce in Oklahoma is growing older. The median age for all active physicians in the state is 50 years. Physicians practicing in Urban Oklahoma tend to be younger, with a median age of 49 years, followed by Mixed at 50 years, and Rural at 5 years. The population pyramids to the right show the number of rural and urban physicians by age cohort. More than 60% of all rural physicians are older than age 50 compared with 49% of urban physicians. Among the primary care specialties, 57% of rural physicians are older than age 50 versus 44% for urban physicians. In 2007, 97 currently active physicians reached age 65. By 208, 24 of the currently active physicians will reach age 65. This overall trend is true for both rural and urban Oklahoma. A recent nation-wide survey, conducted by the Association of American Medical Colleges, revealed that / of active physicians older than age 50 would retire today if they could afford to do so. The eagerness to retire was most prevalent among physicians between the ages of 50 and 59. Undoubtedly, the looming retirement crisis will be especially hard felt in rural Oklahoma where the number of physicians is already at a critical low. 4

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