of physicians in North Carolina by degree and type of practice. My name is Elizabeth Enright. I'm a third year medical student at the Campbell University School of Osteopathic Medicine. I would also like to introduce our two PIs on their behalf, Dr. Godwin Dogby and Dr. Thomas Motika. So our study stemmed from an initial curiosity of DO physicians in North Carolina and how their distribution in our state was influenced by Campbell's opening of the medical school in 2013. North Carolina, like most places in the United States, has limited access to adequate healthcare in its rural areas. For the last 20 years, 14 of the 100 counties in North Carolina have been designated as healthcare professional shortage areas based on provider ratios, population under the poverty level, and other factors. We wanted to delve deeper into how these disparities could be resolved by better understanding physician distribution based on degree, locale, and specialty over a time span of six years from 2013 to 2019. The methods that we utilized for this study were a retrospective analysis of the data set between 2013 and 2019 from the North Carolina Medical Board. This included approximately 50,000 physicians that were licensed within the state during that timeframe. Individual consent was not required as all data was de-identified prior to its usage. Practice location was utilized to distinguish the county of which each physician's office was primarily located and practicing within. Population size was classified as rural or non-rural based on the HPSA and the different definitions within that as well. Specialty was categorized into three groups. 20 were primary care, 28 were target specialty, and the remainder were non-primary care. These definitions were determined based on the agency of healthcare research and quality in addition to Campbell University School of Osteopathic Medicine. SPSS was the software utilized to run the analysis as a whole. If you look over at figure one, you can see that in 2013, you have the distribution between non-rural, rural, and undesignated for the percent of DO versus MD physicians working there during that time. In 2013, there is a larger percentage of DO physicians working within the rural population and a larger percentage of MD physicians working within the non-rural location. In figure two, you can see the same distribution of data within 2019. Most of the numbers stay relatively the same and so that you can see that there is still a higher percentage of DOs within rural and higher percentage of MD physicians within the non-rural location. This is important because the distribution and disproportionate barrier to healthcare for the populations within those areas is much more significant based on what kinds of physicians are present in that population. Three quarters of all physicians within the state of North Carolina do work in only a quarter of the land that is within the state. Overall, you've seen an increase in the number of physicians working within the state from 2013 to 2019. However, you still see this disparity between the different locations. Looking to figure three, the data is arranged to show the percentage of DO and MD physicians through the specialty areas of practice, one being primary care, another being non-primary care and the last target specialty. In 2013, DO physicians held a fairly even distribution across all three of these groups with the most in primary care oriented practices. Whereas MD physicians held a higher number in preference for non-primary care specialties. Looking to figure four, in 2019, these distributions are relatively the same as they were in 2013 with MD physicians greatest in non-primary care and DO physicians fairly distributed across the three groups. As a discussion of this data, rural populations in North Carolina continue to show disproportionate barriers to healthcare access. When combining 2013 and 2019 data for both DOs and MDs overall, non-primary care has the greatest percentages of physicians practicing within it and primary care has the least. This lack of general medical practitioners in those in primary care specialties further perpetuates the strain on primary care physicians in the areas where access to healthcare is limited. Despite the rising number of osteopathic and allopathic physicians in North Carolina. In conclusion, within North Carolina, MD physicians have continuously shown a preference and predominance for practicing in non-rural locations, as well as having a non-primary care specialties. In comparison, DO physicians have shown an even distribution and little to no preference between rural and non-rural locations in the various different specialties that they have to choose from. Future studies should examine and elaborate on the barriers and deterrence that go between both rural practice and primary care specialties in order to determine methods to increase and incentivize physicians to practice and cover that area that is having the most need and the least representative. Thank you so much for listening to our presentation and have a great rest of your day. Thank you.

physician distribution

rural healthcare

DO vs MD

Campbell University

healthcare access disparities