Others practiced in the Federal Government, most in Department of Veterans Affairs hospitals and clinics or in the Public Health Service of the Department of Health and Human Services. While physicians have traditionally been solo practitioners, a growing number are partners or salaried employees of group practices. Organized as clinics or as groups of physicians, medical groups can afford expensive medical equipment and realize other business advantages. D.O.'s tend to practice in small cities and towns and in rural areas. M.D.'s, on the other hand, tend to locate in urban areas, close to hospital and educational centers.
Some rural areas remain underserved, although the situation is improving somewhat.
Osteopathic physicians are located chiefly in States that have osteopathic schools and hospitals. Michigan had the most D.O.'s, followed by Pennsylvania, Ohio, Florida, New Jersey, and Texas. Training and Other Qualifications All States, the District of Columbia, and U.S. territories require physicians to be licensed. Although physicians licensed in one State can usually get a license to practice in another without further examination, some States limit reciprocity. Graduates of foreign medical schools can generally begin practice in the United States after passing an examination and completing a U.S. hospital residency training program.