Introductions

Physicians provide essential services such as diagnosing and treating illnesses and injuries, as well as addressing health maintenance . They may work in clinical settings such as hospitals or physicians’ offices, or in nonclinical settings such as government agencies or nonprofit organizations4. An adequate supply of physicians can help to ensure access to affordable and high-quality health care . Health workforce development strategies in Indiana are important to informing policy and supporting workforce shortage designations. These strategies are informed by health workforce data, including workforce demographics, educational trends, practice characteristics, and services offered. Over the last several years, significant strides have been made to collect comprehensive, accurate, and timely health workforce data which are maintained for longitudinal workforce tracking.

As a research entity supporting the State of Indiana, the Bowen Center for Health Workforce Research and Policy (Bowen Center) is committed to and engaged in developing sustainable data management processes and publishing timely workforce information. This report is intended to provide a snapshot of Indiana physicians actively practicing in Indiana as of November 2023.

There are some limitations to this report that should be noted. First, the information presented in this report is largely based on self-reported data which introduces the potential for some level of response bias. This bias, however, is likely diminished through the statutory requirement for physicians to provide specified information during online renewal, and their attestation that all information provided is accurate. Additionally, changes to the survey tools over the last several biennial renewal cycles limit longitudinal analysis. Care is being taken to minimize the future changes to supplemental survey questions to ensure confidence in future longitudinal analyses.

DATA COLLECTION

The supplemental survey questions administered to physicians during the 2023 license renewal cycle can be found on IU Indianapolis ScholarWorks at https://hdl.handle.net/1805/33433. Supplemental survey data collected during the renewal period and basic licensure data (name, license number, etc.) were extracted and exported into separate text files by the Indiana Professional Licensing Agency (PLA) 30 days after the close of the license renewal period.

DATA MANAGEMENT PROCEDURES

Supplemental survey data were cleaned and coded per processes outlined in the Bowen Center data management procedures document (available at: http://hdl.handle.net/1805/16704). After completing these procedures, the survey data file was merged to the licensure data file by unique license number to create a 2023 Workforce Master File. These Master Files were then uploaded to the Indiana Health Professions Database. Verification and geocoding of license address and self-reported practice addresses were provided by Melissa Data, Inc. Additional variables were generated through these data management processes. A full-time equivalency (FTE) was generated based on self-reported hours in direct patient care, as outlined in Table 1. FTE assignment strategy was implemented for all reported practice locations. Address cleaning and geocoding procedures also resulted in additional variables related to geographic location and rurality based on criteria outlined by the United States Department of Agriculture (more information can be found here: https://www.ers.usda.gov/data-products/rural-urban-commuting-area- codes/documentation/) .

Executive Summary

Physicians play an integral role in health care delivery by performing duties such as diagnosing and treating injuries or illness, addressing health maintenance, providing preventive health care, and counseling patients[1]. The 2023 Indiana Physician Health Workforce Data Report examines the demographics, education, and practice characteristics of licensed physicians serving Indiana residents. These licensed physicians may specialize in areas of practice such as surgery, psychiatry, pediatrics, family medicine, or numerous other areas. Data is collected from physicians every two years during their license renewal period. This data provides a snapshot overview of Indiana’s physician health workforce with some notable longitudinal trends.

In 2023, a total of 32,898 physicians renewed their Indiana license. After excluding those who had an inactive license status and reported not actively providing services in Indiana, a total of 18,586 physicians were identified as Indiana’s Physician Workforce. Of those physicians actively practicing in Indiana, 6,420 physicians were identified as primary care physicians and 782 were identified as psychiatrists. Demographically, the majority of physicians were male (64.4%) and identified as White (67.2%). On average, female physicians (46.6 years) were slightly younger than male physicians (51.0 years). Approximately a quarter (25.2%) of Indiana physicians obtained their medical degree in Indiana. This is a decrease compared to 2021 (27.2%)[2] and 2019 (29.6%)[3]. Similarity, 27.8% reported completing residency training in Indiana, which is also a decrease compared to 2021 (30.1%)2 and 2019 (32.3%)3. The office/clinic and hospital settings were the most frequently reported practice settings for Indiana physicians. A total of 44.3% of physicians reported that their primary practice setting was some form of an office/clinic setting and 37.3% reported some type of hospital setting. The percent of physicians who reported offering telemedicine services (as defined in Section II of this report) rose slightly compared to 2021, though it was not nearly as dramatic as the increase seen throughout the COVID-19 pandemic2.

Based on self-reported practice addresses, across the state there were disparities in the supply and access to physicians, including primary care providers and psychiatrists. While all Indiana counties had at least one reported actively practicing physician in their county, the population to physician FTE ratio for counties ranged from 279.6:1 in Marion County to 43,645.0:1 in Benton County. When examining specific specialties, one Indiana county (Benton County) did not have any reported primary care physicians located in their county and 31 counties had no reported FTE from physicians with a psychiatry specialty.

The descriptive information on Indiana’s physician workforce presented in this report may be helpful to inform related policy and planning initiatives. Demographic information contained herein are relevant for activities related to workforce diversity. Practice characteristics, including geographic distribution of the workforce, are directly relevant to discussions related to access-to-care. Comments and questions regarding this report should be directed to Bowenctr@iu.edu.

[1] Bureau of Labor Statistics, U.S. Department of Labor. (2024, April 17). Physicians and Surgeons. Occupational Outlook Handbook. https://www.bls.gov/ooh/healthcare/physicians-and-surgeons.htm#tab-2

[2] Bowen Center for Health Workforce Research and Policy. (2022). Data Report: Indiana Physician Workforce. https://hdl.handle.net/1805/28950

[3] Bowen Center for Health Workforce Research and Policy. (2020). Data Report: Indiana Physician Workforce. https://hdl.handle.net/1805/22525

Acknowledgements

The Bowen Center for Health Workforce Research and Policy would like to recognize the many individuals and organizations that contributed to making this report possible. The survey tool used to collect the data presented in this report was developed in collaboration with an expert advisory group. The Indiana Professional Licensing Agency administered the survey questions in conjunction with the 2023 physician license renewal process. The Office of the Dean, Division of Applications Development provided collaborative and technical support for data management.