Special Report

7 Cities Losing Their Doctors

7. Kankakee, IL
> Pct. chg. primary care physicians 2010-2013: -10.2%
>Primary care physicians: 42.8 per 100,000
>Pct. population 65 and older: 14.8%
>Median household income: $51,000

The number of primary care physicians per capita declined by more than 10% in Kankakee, Illinois, the seventh largest drop of any U.S. city. In most of the cities shedding doctors jobs, relatively fast overall population growth contributed to the steep declines in per capita primary care physicians. However, this is not the case in Kankakee, where the population actually declined between 2010 and 2013 — by 1.1%.

Even before the precipitous drop in the primary care physicians available to the city, Kankakee was not an especially popular place for M.D.s. There were only 47.6 primary care physicians for every 100,000 area residents in 2010, far fewer than the national ratio of 73.0 doctors for every 100,000 Americans. As of 2013, there were only 42.8 primary care physicians for every 100,000 Kankakee residents compared to a the national ratio of 75.7 per 100,000.

6. Brunswick, GA
> Pct. chg. primary care physicians 2010-2013: -10.3%
>Primary care physicians: 43.0 per 100,000
>Pct. population 65 and older: 17.7%
>Median household income: $44,055

Physicians practicing medicine in affluent areas tend to earn more money, while doctors in lower-income areas typically earn lower incomes. With a median household income of $44,055, nearly $10,000 less than the national median income, Brunswick, Georgia, is one of the poorest cities in the country. Many residents may struggle to afford medical care, and many may also not go to the doctor at all. Among those too young to qualify for Medicare, the city’s uninsured rate of 19.8% is considerably higher than the 13.5% national uninsured rate.

With low incomes and nearly one of the highest uninsured rates in the country, it is perhaps not surprising that the number of primary care physicians as a share of the population is falling in Brunswick. The share of doctors in the city dropped by 10.3% between 2010 and 2013, while the share nationwide increased by 3.7%. As of 2013, there were only 43.0 primary care physicians in Brunswick for every 100,000 residents, one of the smallest ratios of any U.S. city.

5. Morristown, TN
> Pct. chg. primary care physicians 2010-2013: -10.8%
>Primary care physicians: 55.5 per 100,000
>Pct. population 65 and older: 18.3%
>Median household income: $39,822

The elderly are at greater risk of a number of serious health complications and conditions, and as a result, they often require more frequent doctor visits. In Morristown, 18.3% of the population is 65 and older, a far greater share than the 14.5% of Americans who are this age. While an older population would suggest a greater demand for doctors, there are only 55.5 primary care physicians for every 100,000 city residents, far fewer than the 75.7 per 100,000 national share. Despite a likely higher need, the city’s share of primary care doctors dropped by 10.8% in recent years, a steeper decline than in all but a handful of other U.S. metro areas.

Most doctors have invested a great deal of time and money acquiring their skill set, and usually seek appropriately high salaries. As a result, economically depressed areas may be less attractive to practicing M.D.s. In Morristown, Tennessee, nearly one in five people live in poverty, and the typical household earns only $39,822 annually, far less than the $53,482 a typical household earns nationwide.

4. Cheyenne, WY
> Pct. chg. primary care physicians 2010-2013: -12.2%
>Primary care physicians: 65.6 per 100,000
>Pct. population 65 and older: 14.4%
>Median household income: $58,324

Cheyenne’s population expanded relatively fast between 2010 and 2013. Over that period, Cheyenne’s total population grew by 4.0%, well above the corresponding nationwide growth. Despite fast population growth, the number of doctors in Cheyenne actually decreased. Adjusting for population, there were 12.2% fewer primary care physicians in Cheyenne in 2013 than there were in 2010.

The city’s declining share of medical doctors stands in stark contrast to the 3.7% national increase. There were 74.8 primary care physicians in Cheyenne for every 100,000 residents in 2010, slightly more than the 73.0 per 100,000 national ratio. By 2013, there were only 65.6 primary care physicians in the area for every 100,000 residents, considerably less than the 75.7 doctors per 100,000 Americans.

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