The Cattaneo & Stroud, Inc. Physician Need Ratios provide an objective, standardized tool for determining community need for physicians when applied as part of a carefully constructed analysis of market characteristics and practicing physicians. Documentation of assumptions and findings is essential to the appropriate application of the ratios for a specific market area. Due to the changing nature of medical practices and communities, we recommend an update of physician need estimates a minimum of every three years, to ensure strategic plans and regulatory compliance standards are met. Furthermore, current inventories of practicing physicians in a specialty should be confirmed at the time a specific recruitment agreement is negotiated in order to substantiate current need in the community.