Public Health and Primary CareORIGINAL ARTICLE

Modeling the importance of physician training in practice location for Ohio otolaryngologists

Samuel Borgemenke, BS; D’Nair Newsom, BS; Patrick Scheatzle, BA; Nicholas Durstock, BS; and Elizabeth A. Beverly, PhD
Notes and Affiliations
Notes and Affiliations

Received: February 23, 2024

Accepted: August 19, 2024

Published: September 27, 2024

  • Samuel Borgemenke, BS, 

    Department of Medicine, Ohio University Heritage College of Osteopathic Medicine, The Ohio University Diabetes Institute, Athens, OH, USA

  • D’Nair Newsom, BS, 

    Department of Medicine, Ohio University Heritage College of Osteopathic Medicine, The Ohio University Diabetes Institute, Athens, OH, USA

  • Patrick Scheatzle, BA, 

    Department of Medicine, Ohio University Heritage College of Osteopathic Medicine, The Ohio University Diabetes Institute, Athens, OH, USA

  • Nicholas Durstock, BS, 

    Department of Medicine, Ohio University Heritage College of Osteopathic Medicine, The Ohio University Diabetes Institute, Athens, OH, USA

  • Elizabeth A. Beverly, PhD, 

    Department of Primary Care, Ohio University Heritage College of Osteopathic Medicine, 1 Ohio University, Athens, OH, USA

Abstract

Context: Underserved communities in southeastern Ohio and Appalachia face significant healthcare accessibility challenges, with the Midwest offering a lower density of healthcare providers compared to coastal regions. Specifically, underserved communities in southeastern Ohio and Appalachia are disadvantaged in otolaryngology care.

Objectives: This analysis aims to identify factors that lead otolaryngologists to a respective practice location, and if any of that influence comes from where otolaryngologists completed their medical education.

Methods: The proportion of otolaryngologists who performed medical school, residency, and/or fellowship in Ohio was analyzed utilizing a three-sample test for equality. Multivariate logistic regression and Pearson prediction models were produced to analyze the impact of performing medical training (medical school, residency, and fellowship) in Ohio.

Results: Going to medical school in Ohio significantly increases the odds of going to an otolaryngology residency in the state (p<0.001). Moreover, between medical school and residency, medical school was a significantly better predictor of otolaryngologists practicing in Appalachia (Δ Bayesian Information Criterion [BIC]>2) and southeast Ohio (ΔBIC>10). Medical school in state was also a better predictor of percent rural and median household income than residency (ΔBIC>10). The multivariate model of medical school and residency was significantly better than either predictor alone for the population (ΔBIC>2). All models predicting percent rural were significantly improved with the addition of a Doctor of Osteopathy (DO) degree (ΔBIC>10).

Conclusions: Where physicians complete their medical training (medical school, residency, and fellowship) in state has a significant impact on predicting their future place of practice. This study found that the location of such training has a positive predictive nature as to whether that physician will practice in a rural and underserved area in the future. Notably, the addition of being licensed as a DO also increased the probability of that physician practicing in a rural area.

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