Geographic imbalances in the distribution of doctors and health care services in OECD countries

The uneven geographic distribution of doctors is one of the most common health workforce policy challenges OECD countries currently face. This chapter provides an overview of this distribution challenge by presenting data on the number of doctors across different regions in OECD countries. It examines the reasons why doctors choose to take up practice in some places, but not in others, and analyses policy responses intended to tackle uneven distribution of doctors. Countries can use three types of strategies, possibly in combination: first, they can aim to select and train future doctors in such a way that they will hopefully distribute more evenly second, they can try to influence the choice of practice location of new doctors through regulation and financial incentives and third, they can reform health care delivery in order to be able to provide needed services with fewer doctors by extending the scope of practice of nurses, pharmacists or other providers. Telemedicine is also seen as another increasingly feasible and potentially more efficient option to connect patients and physicians at a distance. While the broad characteristics of these potentially useful interventions can be identified, more robust and regular evaluations are required to determine what policies work to tackle imbalances in physician supply in each context.