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Psychiatric Manpower RatiosA Beguiling Numbers Game?
Lorrin M. Koran, MD
Arch Gen Psychiatry. 1979;36(13):1409-1415.
Abstract
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• Many characteristics of California's counties that correlate with physician-population ratios also correlate with psychiatristpopulation ratios, with their changes through time and with rural counties' ability to attract psychiatrists. These same county characteristics seem to influence the uneven distribution of lawyers throughout the state, a fact that should help physicians help legislators understand problems in attempting to equalize manpower distribution. California's relatively high psychiatristpopulation ratio and the presence of counties that are statistically anomalous should preclude the application of these findings to other states. Despite government interest in psychiatristpopulation ratios as a device to estimate manpower needs, these ratios are a poor measure of access to services. Barriers to care such as lack of private insurance coverage and Medicaid and Medicare restrictions appear more powerful than uneven manpower distribution. Proposals for influencing psychiatrists' distribution should be compared with other methods of decreasing mental illness morbidity, such as mandating insurance coverage and increasing funds for preventive services and research.
Author Affiliations
From the Department of Psychiatry, Stanford University Medical Center; and the Institute for Medical Research, Stanford, Calif.
Footnotes
Accepted for publication June 28, 1979.
Reprint requests to Department of Psychiatry, TD 104E, Stanford University Medical Center, Stanford, CA 94305 (Dr Koran).
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THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Psychiatrists' Distribution Across the 50 States, 1978
Koran
Arch Gen Psychiatry 1981;38:1155-1159.
ABSTRACT
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