"Narrow" doesn't mean "inadequate". It just means that instead of having access to 75% of doctors in your area, you only have access to 25%. But you still have multiple specialists in each area, and you still have hospitals you can go to. Most people don't even scroll past the first page of results in a doctor search anyway, so would having access to 200 dermatologists provide much difference versus having access to 50?

Very little of what we do in modern medicine can't be done by local hospitals. Most diseases have well-understood treatment protocols that don't vary much between hospitals or doctors. Cutting edge treatments are only necessary in a very small percentage of cases, which often increases costs because if a hospital has a new piece of expensive equipment, they're going to be more inclined to use it, even in cases where it's not necessary and the old technology is better understood.

There is a false belief in this country that more health care or more advanced technology actually creates better outcomes for patients. In many cases, all the new technology creates are profits for the hospitals and medical device companies.