First Advisor

Ryan Petteway

Date of Award


Document Type


Degree Name

Bachelor of Science (B.S.) in Health Studies: Health Sciences and University Honors


Health Studies


Medically underserved areas, Physicians -- Supply and demand, Employee retention




In the midst of the current United States healthcare crisis, the shortage of primary care physicians is becoming increasingly evident. Its prevalence, although seen nationwide, directly affects specific states, creating what are known as Health Professional Shortage Areas, or HPSAs. HPSAs have a substantial lack in primary care providers in comparison to the number of individuals in a specified geographic location. Oregon in particular, is home to 120 HPSAs, with current shortages of approximately 600 physicians: a deficit expected to reach 1,500 by the year 2030 (OHWI, 2011).

While there are multiple elements that contribute to the development of HPSAs, the focus here was to examine potential reasons post-residency doctors with a primary care (PC) specialty leave the states in which they trained. Examining this in Oregon, and comparing the dynamics of Oregon to those of Arizona and South Carolina--states with similar geographic and demographic characteristics--can help us understand and address the growing shortage of primary care physicians.

The work presented here examines potential contributing causes of Oregon PC HPSAs, with a focus on two specific factors: reported decreases in the number of medical students practicing primary care, and misdirection of programs intended to promote primary care physicians to practice within the state. HPSA dynamics in South Carolina and Arizona are discussed for comparative context to inform and guide interpretation of Oregon dynamics, and to help elucidate potentially unique or overlapping factors between demographically and geographically (urban/rural) similar states. This paper closes with some preliminary recommendations to guide efforts to ensuring that all Oregonians have reliable, inclusive, and equitable access to the care they need.


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