To the Editor.
—By highlighting the issue of physician migration and linking it to graduate medical education (GME), Dr Seifer and colleagues1 have contributed to the recognition that we now have a national market for medical education and physician services. They suggest that states with medical training institutions having national reputations do not necessarily distribute their products nationally, while states that try to deploy local trainees to their own hinterlands often lose them to other states. However, their finding that "[o]verall, 51% of physicians are practicing in the state in which they obtained their graduate medical education" may understate the true nature, extent, and meaning of geographic mobility over the life span of physicians and may overlook some of the downstream policy implications.We have recently examined physician migration into and out of rural counties in the 48 contiguous states from 1987 to 1990, using annual address changes from
Konrad TR, Li H. Migrating Docs: Studying Physician Practice Location. JAMA. 1995;274(24):1914. doi:10.1001/jama.1995.03530240024033