Future Supply Of Physicians Research Articles

Methodological issues and policy implications of physician manpower forecasting

Future physician supply is a matter of concern in most industrialized countries due to its impact on cost and quality of health care. Consequently, forecasting the number of physicians becomes an important research issue from both methodological and policy perspectives. This article presents a simple forecast model developed for the State of Wisconsin (U.S.A.), using the complex federal model of the U.S. Graduate Medical Education National Advisory Committee as a backdrop. In this context, the article discusses the main determinants of physician supply, such as mobility, retention, ageing and productivity. The methodological issues in the simple modelling of such phenomena are examined using the Wisconsin case as an empirical example. Finally, policy implications of planning physician supply with respect to projected demand for services, changes in reimbursement patterns and productivity are discussed along with some of the recommendations actually made to the Wisconsin Legislature.

A New Physician Supply Policy Is Needed

THE PUBLICATION of Estimates of Physician Requirements for 1990 for the Specialties of Neurology, Anesthesiology, Nuclear Medicine, Pathology, Physical Medicine and Rehabilitation, and Radiology: A Further Application of the GMENAC Methodology (p 2623) covering six specialties that were not included in the original GMENAC report is a reminder that the findings of Dr Alvin Tarlov and his legion of collaborators remain on the nation's health agenda. There are many important questions about the future supply of physicians that warrant attention by members of the profession and its leaders. These include the determination of whether an oversupply threatens or is already here; the criteria for reaching a judgment about the adequacy of the supply; the extent to which factors on the demand side, eg, pressures to reduce reimbursement or the growing number of the elderly, will affect physicians' work loads; conflicts with nurse practitioners and nonmedical providers over turf; the rate

The future supply of physicians: from pluralism to policy.

Research Article Health AffairsVol. 1, No. 4 The Future Supply of Physicians: From Pluralism to PolicyEli Ginzberg AffiliationsColumbia University in New York CityPUBLISHED:Fall 1982No Accesshttps://doi.org/10.1377/hlthaff.1.4.6AboutSectionsView articleView Full TextView PDFPermissions ShareShare onFacebookTwitterLinked InRedditEmail ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions View articleTOPICSMedical educationPhysiciansTeaching hospitalsAccess to careGrantsClinical careMedical researchOrganization of careCost reductionHospital costs Loading Comments... Please enable JavaScript to view the comments powered by Disqus. DetailsExhibitsReferencesRelated Article MetricsCitations: Crossref 7 History Published online 1 January 1982 InformationCopyright © by Project HOPE: The People-to-People Health Foundation, Inc.ACKNOWLEDGMENTSPreparation of this paper, and the ongoing study of the expanding physician supply on which it is based, have been generously supported by The Robert Wood Johnson Foundation.PDF downloadCited byNegotiating Ambivalence: The Social Power of Muslim Community-Based Health Organizations in America24 November 2010 | PoLAR: Political and Legal Anthropology Review, Vol. 33, No. 2Solutions in a Pluralistic EnvironmentNursing Clinics of North America, Vol. 25, No. 3Hospital Behavior in a Local Market Context19 August 2016 | Medical Care Review, Vol. 43, No. 2The Future Supply of PhysiciansNew England Journal of Medicine, Vol. 314, No. 13Academic Health Centers: A Troubled FutureEli Ginzberg24 July 2017 | Health Affairs, Vol. 4, No. 2Medical Education in the United States: A Resource for the Third World?Donald O. Nutter24 July 2017 | Health Affairs, Vol. 3, No. 1Cost Containment — Imaginary and RealNew England Journal of Medicine, Vol. 308, No. 20

GMENAC: its manpower forecasting framework.

The Graduate Medical Education National Advisory Committee (GMENAC) was an advisory group to the Secretary, US Department of Health and Human Services. Its charter ended September 30, 1980. It submitted 107 recommendations to achieve a better balance between future physician requirements and future physician supply, by specialty and geography. Among its contributions were the development of a manpower forecasting framework and series of models which are described here, together with the results of these models. These models may have significant utility in future human resource planning at both national and local levels.

The Expanding Physician Supply and Health Policy: The Clouded Outlook

Our conclusions about consensus and policy follow: -The interested parties from the citizenry to the leaders of specialty societies are definitely not of one mind whether the increasing number of physicians is to be viewed as boon or bane. -If over the next few years the much enlarged supply of physicians is seen as creating more problems than it is solving, the step from consensus to policy will still prove difficult. -The absence of early consensus or specific action does not imply that the future supply of physicians is not being influences. The cutbacks in federal support for medical students are certain to have a dampening effect sooner or later on the numbers that will seek admission to medical school. -The marker signals that physicians' incomes are lagging behind other professionals and that government is increasing its control over medical practice will also have an effect on many premedical students, some of whom will choose other careers. -The changes in payment mechanisms and the delivery of heath care will have important long-term consequences for the effective demand for physician services, which in turn will influence future medical school enrollments.

United States Citizens in Foreign Medical Schools and the Future Supply of Physicians

Between 1973 and 1977, the number of United States citizens in foreign medical schools increased from 12,000 to 15,000, with Mexico and Italy responsible for training 55 per cent of these students. If all these students can successfully meet the requirements for entry into graduate training in the United States, their numbers, combined with the increasing size of entering classes in American medical schools, may exceed the number of positions presently available for first-year graduate training. Serious problems in the quality of education received in several new foreign medical schools must be addressed if these students are to enter the American medical system.

Social Class in Relation to Medical School Performance and Choice of Specialty

Summary American medical students come from higher-status backgrounds than would be true if sampling occurred on a random probability basis from the general population. With use of Hollingshead's method of scoring for upper, upper-middle, lower-middle, upper-lower, and lower-lower classifications, estimated incidences for medical students are 32.2%, 22.4%, 26.9%, 14.8%, and 3.7%, as compared with 3%, 11%, 32%, 40%, and 14% for people-in-general. Socioeconomic status is relatively uncorrelated with the premedical academic performance of admitted students and is only slightly related to scholastic and clinical achievement in medical school. Graduates with working class parents tend more often to choose careers in general practice or family medicine. Increased selection of applicants from low status backgrounds would seem to involve few if any dangers and might well contribute to a more abundant future supply of physicians offering primary care.