Heavy traffic: Are doctors avoiding exurbia?

Homeowners, stores and restaurants are pushing the suburbs ever farther from their mother cities, but doctors aren't so quick to follow.

By Bob Cook, AMNews staff. July 2, 2001.

For James Cruse, MD, being a primary care physician in the second-fastest-growing county in the nation means, thanks to specialists desperate for his referrals, often not having to pay for lunch. Or dinner. Or Ricky Martin tickets. Or symphony concerts. Or baseball games.

And it also means never having to take on a managed care contract he doesn't like.

Dr. Cruse's enviable perch in his Cumming, Ga., office comes from a simple supply-and-demand equation. Many of the fastest-growing counties in the nation, like Dr. Cruse's Forsyth County outside Atlanta, are exurban. Exurban counties are part of a metropolitan area, yet they do not contain the city that defines the area.

But while the Targets and Home Depots in the world are rushing to build in these communities, so far it appears physicians are slower to make a move.

Although no data are available nationwide on physician-population ratios in the fastest-growing counties as identified in the 2000 U.S. Census, some localities have done their own checking.

For example, in Georgia, the primary care physician-to-patient ratio in the fastest-growing counties is about 45 per 100,000 -- only slightly more than the rate for so-called "lagging" rural areas, according to a Mercer University School of Medicine study. The Forsyth County government, at last count, said 42 primary care doctors were within its borders.

"There's a shortage out there," said Dr. Cruse, whose two-physician practice has tried without success for six months to hire a third doctor. [...]