Intraurban physician location: A case study of Phoenix

The focus of this paper is the intraurban distribution of private practice physicians. Based on physicians' level of specialization and time spent in hospitals, a four celled locational model is proposed. The model presumes that specialists are more spatially concentrated near the urban center than physicians who perform primary care functions. On a smaller scale, physicians who are required by the nature of their work to spend a large portion of their day in hospitals are expected to be more clustered around hospitals than such physician types as dermatologists or ophthalmologists who are less hospital oriented. Four hypothetical spatial patterns are suggested, and physician types are fit into appropriate categories on the basis of their expected concentration near the city center and degree of clustering around hospitals. The locational characteristics of 14 physician types are examined for the Phoenix metropolitan area in 1970. Standard distance statistics and dot maps are used to determine the actual extent of concentration and clustering. Although physician types in Phoenix generally conformed to expected patterns, all of them exhibited a higher degree of both concentration and clustering than the idealized distributions. The greatest deviations occurred in the cases of internists and pediatricians who were hypothesized to follow a dispersed and non-clustered distribution. Pediatricians, in particular, seemed inappropriately positioned relative to their target population. They were highly concentrated near the city center in spite of the fact that their patients, children, tend to reside in new housing on the periphery of the urbanized area. The investigation generally showed an extremely unequal distribution of private practice physicians in the Phoenix metropolitan area. Implications arise in the area of intraurban travel where the urban population makes excessively long trips to obtain medical care because physicians have located in a manner that is convenient for them but inefficient for their patients.