How Many Doctors?

Abstract

C RECENT spell in Australia as a visiting professor rekindled anxieties in my mind over medical manpower fyA 2 and its assessment. Australia has now reached a doctori! Lw 5 surplus with more than 1 physician to 500 persons compared to the United Kingdom rate of 1 to 700 and that in the United States, 1 to 6oo. Not only that but the Australianis are producing annually one new medical graduate for every io,ooo of the population, and in the United Kingdom and the United States we are producing one for every 14,000. The Australians are heading for problems of medical oversupply. It may be wondered how this situation has arisen, and let us admit at once that the Australian problems are shared by all developed countries. Everywhere we are producing too many doctors. The reasons for such excesses can be explained simply as due to lack of data and information based on any reliable evidence from trials and experiments. The ways in which manpower needs usually are predicted is for a committee to sit around a table, to ponder over estimations of future population growth, to relate this to current numbers of medical personnel and population, and then to add on a little more, "just in case." A graph is then drawn and the number of future doctors required is marked off in hope. Such planning would be reasonable if the costs of doctors were less. It has been estimated in the United Kingdom that each new medical graduate entails a professional lifetime capital expenditure of around $5 million by British taxpayers. The British story of medical manpower planning is one often-year pendulum swings. In the 1940S the Goodenough Committee reported a shortage of doctors, and so more students were encouraged to enter medical schools. In the 1950S the Willink Committee reported that we had too many doctors, and so entry into medical schools was reduced. In the 196os