Trends in physician availability in 10 urban areas from 1963 to 1980.

The overall growth in the physician supply has so dominated the public policy agenda that issues of physician distribution within urban areas have received little attention. In this study, we examined the changes in physician availability in the poverty and nonpoverty areas of 10 U.S. cities between 1963 and 1980. We found that the overall availability of patient care physicians increased in both poverty and nonpoverty areas, with greater growth in the nonpoverty areas. For office-based primary care physicians, however, there was a 45% decline in availability in the poverty areas and a 27% decline in the nonpoverty areas. We conclude that the overall increase in the physician supply may not adequately correct geographic and specialty maldistribution in urban areas. We suggest that special educational, service delivery, and financing strategies within urban areas continue to be needed to address problems of inequitable physician availability.