The Optimal Location of Doctors

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Abstract
There is a presumption in the health-care literature that doctors in the United States are geographically maldistributed. Yet there has been little discussion of the appropriate way to evaluate patterns of location. This paper discusses four different criteria for determining the optimal geographic distribution of doctors, all of which are implicit in the literature: economic efficiency, maximization of health, equalization of doctor/patient ratios, and equalization of health. A simple example is used to illustrate the different distributions of physicians that each goal may imply. Proper governmental policy fundamentally depends on the exact criterion chosen. I argue that health maximization is the most justifiable objective. (N Engl J Med. 1982; 306:397–401.)

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