Predicting the need for primary care specialists: the example of a southwestern state.

Because of a need to project the requirements for the training of primary care practitioners in the state of New Mexico, we reviewed available means of determining health manpower needs. Combining several of these methods, we constructed a three-tiered model, taking into account different patterns of care-seeking in areas of various population densities. These methods may be applicable in other states like New Mexico where densely populated cities contrast with sparsely settled rural areas. All such methods, however, are confounded by the state of balance of many factors, including immigration and emigration of physicians, use of nonphysician providers, and patient movement across boundaries for care. This report contributes to the growing literature on health manpower needs by recognizing and attempting to account for differences between urban and rural patterns of care-seeking.