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The results are reported from a mail survey to a 25 percent sample of all allopathic and osteopathic physicians practicing in countries less than 10,000 population in 1988. Overall, 71 percent of respondents indicated that they were satisfied with their practice in those areas but 23 percent indicated dissatisfaction and 26 percent planned to leave those areas within five years. Factors associated with practice dissatisfaction included lower income, long hours worked, increase in patients with inadequate medical insurance and distance from a major referral center. Thirty-two percent of respondents indicated that there were too few physicians in their counties and in aggregate projected a need for 1,100 additional physicians, or approximately a 50 percent increase relative to the current supply of physicians in such counties. Seventy-four percent of those indicating a need for more physicians stated that in their opinion the community in which they were practicing could support such additions. The survey results indicate an underlying satisfaction with rural practice but suggest the need for ongoing educational and financial incentives for such practices if the delivery of health care services in rural areas is to be improved.

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This study examines the supply and selected characteristics of nurses working in nonmetropolitan areas of the United States using the most recent data reported in the third national sample survey of registered nurses in 1988. Nursing supply is analyzed in terms of the ratio of registered nurses per 100,000 people for three standard nonmetropolitan census county size classifications and nine regional groupings of states. Seven dimensions relating to the educational background and current professional characteristics of registered nurses are studied. Findings indicate a notable difference in the ratio of nurses per population across county size and regions of the country. In terms of characteristics selected for this study, the educational background, salary gap, and time spent in various activities differentiate nurses in rural areas from those working in urban counties. Results of this study should be particularly relevant because a variety of educational, financial, and other incentives are being considered to address what is perceived to be a crisis in rural nursing availability.