Although physician workforce planning approaches the need for physicians of each specialty individually, in fact many services are provided by physicians of several specialties. Further, there is some evidence that physicians adjust the scope and balance of services they provide when there are too few physicians of other specialties in their communities, although when this “service shifting” happens and for which services and specialties is not known.

This report uses Medicare data to assess changes in the number of outpatient visits made to various specialty groups for atrial fibrillation and for esophageal, gastric, and duodenal disorders in rural areas that vary in their local availability of cardiologists and gastroenterologists, respectively.