Fewer and More Specialized: A New Assessment of Physician Supply in California

Kevin Grumbach, MD, Arpita Chattopadhyay, PhD, and Andrew B. Bindman, MD

This report presents the first comprehensive study of the Medical Board of California survey data on practicing physicians in the state. It finds fewer MDs than previously estimated, and that specialists outnumber primary care physicians by a 2-to-1 ratio.

June 2009

This report presents the findings of the first comprehensive study of the Medical Board of California survey data on practicing physicians in the state. The data were used to enumerate, more accurately than had been done previously, MD patient care physicians actively practicing in California in 2008, for the state overall, and by individual county. The results show that:

  • The overall supply of MD physicians in the state is 17% lower than that estimated from American Medical Association (AMA) Physician Masterfile data.
  • Of active patient care physicians in California, 34% were in primary care, which is 20% less than the estimate from AMA data.
  • The number of primary care physicians actively practicing in California is at the very bottom range of, or below, the state's need based on Council on Graduate Medical Education estimates.
  • There is an abundance of specialists practicing in the state, though geographically they are unevenly distributed.
  • Rural counties suffer from low physician practice rates and from a diminishing supply of primary care physicians.

If these trends continue, the shortage of primary care physicians in California is likely to worsen, which could pose a significant threat to health care access in the state.

The report also discusses a number of steps California policymakers might consider to address these problems, including creating financial incentives and advocacy to encourage primary care physicians to practice in California and to modernize their practices, especially in underserved areas; increasing the number of new providers entering primary care and practicing in underserved areas by supporting targeted training programs; investing in information technology to support systems improvements and connections across practices; and investing in the continued monitoring of the state's health care workforce.

The complete report is available under Document Downloads, along with an Excel spreadsheet showing the number of physicians, by specialty, for each California county.