In the South Bronx the ratio is one per 10,000. In a system where care is based on ability to pay, there is little incentive for doctors to work in poor neighborhoods. Health care personnel locate in clusters where other health care people are. E.g., the best health care facilities attract the best doctors. The lack of health care personnel perpetuates itself.
Doctors prefer to company of other doctors for referrals, professional association, etc.
The Middle Class Middle-class people are likely to go to private care physicians who are their regular source of medical care. They are more likely to be aware of existing conditions They are more likely to know the patient as a person 2. The poor receive medical treatment, not from private physicians, but from emergency rooms, hospital clinics, public hospitals, and from Medicaid mills. Patients usually do not see the same doctors Emergency room care focuses of relief from the symptom and not on the condition. Detailed medical histories are not taken The use of lab tests is minimal.