Shortage Of Specialists Research Articles

Modernising cancer servicesEdition: 1st Mark RBaker Modernising cancer servicesRadcliffe Medical Press224£27.50185775459X185775459X

Beginning with the stark fact that UK cancer services have failed to keep pace with other developed countries through under investment and specialist shortages, this book is compelling reading. It covers epidemiology, genetics, screening, palliation, and service improvements, focusing on education, research, and multi-disciplinary care.

There's a shortage of specialists: is anyone listening?

The author critiques the long-standing belief that there will be too many physicians, particularly specialists, a view put forth by the Bureau of Health Professions and the Council on Graduate Medical Education in the 1990s and held by many medical organizations, including the Association of American Medical Colleges. He cites his own research, which predicts, to the contrary, that the United States will experience progressively more severe shortages of specialists, and he quotes a wide variety of anecdotal evidence indicating that such shortages are beginning to appear already. He maintains that most previous workforce studies were handicapped by their use of micro-quantitative models. Instead, his research has been structured around four broad trends: economic expansion (which directly influences the demand for physicians), physician work-effort (which is declining), the provision of physicians' services by non-physician clinicians (which is increasing), and the growth of the U.S. population (which often has not been factored in adequately). It is the intertwining of these four major trends that reveals the impending shortages of physicians. He recommends that attention be directed to training more specialists, but cautions against a further dependence on international medical graduates to fill the gap. Instead, he calls upon academic medicine to expand the infrastructure for medical education. However, despite what he sees as a growing cacophony of voices expressing alarm about the developing shortages, he is concerned that academic medicine may not be listening.

The 30th anniversary of the American Board of Allergy and Immunology: Then and now

Thirty years ago the Allergy Subspecialty Boards of the American Board of Pediatrics (ABP) and the American Board of Internal Medicine (ABIM) merged to form the American Board of Allergy and Immunology (ABAI). The ABAI mission was to: establish qualifications and examine physician candidates for certification as specialists in allergy and immunology; serve the public, physicians, hospitals, and medical schools by providing the names of physicians certified by the Board; assist educational and professional organizations to improve the quality of care and availability of allergists to deliver such care, to establish and improve standards for the teaching of allergy and immunology, to establish standards for training programs, and to encourage development of increased opportunities for training of physicians interested in allergy and immunology. This mission statement has guided the activities of the Board ever since by providing a strong focus on the 2 major responsibilities: examining and certifying candidates in a fair objective way, and setting standards for the content and conduct of training programs.

Medical specialists servicing the New England Health Area of New South Wales.

There is increasing emphasis on research, policy and program activity to recruit and retain rural general practitioners in Australia. In contrast, until recently, there has been less attention paid to specific policies and programs relating to rural medical specialists. The New England Area Health Service experiences a shortage of general practitioners and specialists. This study surveyed this region's specialist workforce in 1998 and aimed to identify recruitment and retention issues affecting specialist rural workforce planning in north-west New South Wales. All 91 medical specialists practising in this rural area were surveyed. Seventy-one completed survey forms were received, representing a response rate of 78%. Positive features of rural specialist practice included the rural lifestyle, professional autonomy and available medical infrastructure. Negative features included professional isolation, long working hours, lack of locum relief and inadequate remuneration. Almost all surveyed specialists believe that there is a shortage of specialists servicing the New England Health Area. The major deficits in specialty areas identified relate to: dermatology; ear, nose and throat; obstetrics and gynaecology; orthopaedics; paediatrics; and urology. Recruiting and retaining medical specialists would be facilitated by improvements in the following areas: specialist resources and facilities, specialist locum scheme, remuneration and professional support. Effective strategies need to take account of local circumstances and be based on discussions involving all local key stakeholders.

Mental Health Services in Army Primary Care: The Need for a Collaborative Health Care Agenda

Epidemiologic studies have shown that more than half of mentally ill patients in the United States receive their psychiatric care exclusively in primary care settings. This fraction may be even higher in the military due to concern over possible occupational repercussions resulting from use of specialty psychiatric care and specialist shortages. Collaboration between generalists and mental health care specialists could potentially improve mental health care delivery and reduce psychiatric disability for a large segment of the Army population who have a psychiatric disorder but may not seek specialty care. Collaborative efforts can reinforce military generalists' essential gate-keeping function, thereby decreasing unnecessary medical utilization and health care costs. The authors review the problems associated with mental health care delivery in primary care and provide examples of collaborative models previously studied or currently being explored. A four-part Army Primary Care-Mental Health Services Agenda is proposed, consisting of: (1) coordinated research including primary care-mental health services research and community-based epidemiologic studies; (2) formation of a primary care-mental health services advisory committee for aiding with policy and program development; (3) graduate and continuing medical education in primary care-mental health services emphasizing interdisciplinary collaborative skills; and (4) clinical implementation of feasible collaborative interdisciplinary mental health care models adapted to the range of unique Army primary care settings. The main goal of the Army Primary Care-Mental Health Services Agenda is to improve access to Army mental health care in the most efficacious and cost-effective way and to help minimize the organizational impact of disability related to psychosocial distress.

A Possible Method for the Rapid Assessment of Biodiversity

Inventories of vertebrate and flowering plants are frequently used as surrogates for estimates of total biodiversity. This is in part because the inclusion of invertebrates and nonflowering plants is perceived as being too time‐consuming, costly, and difficult because of the shortage of specialists. Estimates of the species richness of field samples of spiders, ants, polychaetes, and mosses made by a biodiversity technician and by specialist taxonomists were compared. The biodiversity technician received a few hours training in the taxonomy of each group and separated specimens into recognizable taxonomic units (RTUs). The specialists sorted to species. For the three animal groups the biodiversity technician recorded 165 taxa and the specialists 147, with the error for the ants and spiders being 13% or less. A small amount of splitting and lumping of species was detected. The concordance of estimates remained very similar when small subsamples were used. The procedure was repeated by 13 undergraduates using a subsample of spiders. Their average error was 14.4%. The greatest similarity in estimates was for the mosses, but with high levels of splitting and lumping this result was entirely fortuitous. The results suggest that RTU estimates made by biodiversity technicians may be sufficiently close to formal taxonomic estimates of species richness to be useful for the rapid assessment of biodiversity. They also show, however, that the procedures outlined here should be used on invertebrate and nonflowering plant groups before they can be confidently included in biodiversity surveys.

Preventive Medicine Residency Training: A Resident's Perspective

Preventive medicine as a discipline confronts considerable internal and external pressure today about society's needs for prevention specialists. Training in the field has remained static in the face of great changes. This article asserts the need to reassess the philosophy, content, and structure of graduate training in preventive medicine. The field of preventive medicine faces an identity crisis of its own making, trying to be everything to everybody. The need for funding to overcome the shortage of specialists remains a critical but difficult issue that demands innovative solutions.

US manpower: Shortages of specialists foreseen

US manpower: Shortages of specialists foreseen

Opinions among Norweigian dentists on specialization and/or general practice.

Three special areas of dental practice are recognized by the Norwegian Dental Association: oral surgery, orthodontics, and periodontics. A representative, nationwide sample comprising 50 dentists in Norway was surveyed through personal interviews concerning opinions about specialists and further specialization. Two dentists in the sample were specialists, the remaining general practitioners. Two-thirds of this group thought that the specialization of dentistry would continue. Only 11 dentists, however, considered this development to be desirable. Every second stated nevertheless that there was a shortage of specialists, particularly orthodonists, in the district where they practice. Most respondents had good experiences cooperating with specialists but they were against astablishing new specialities; they were concerned about their own scope of acitivity. Some pointed out that it requires greater skill and ability to be a solo general practitioner in a rural district than to be an urban, centrally located specialist. However, only 13 dentists considered it right to make general practice a "specialty".

India. Teaching of population dynamics and family planning in the curriculum of undergraduate medical education.

It is of great importance that the young Indian doctor be well informed on different aspects of population problems and family planning programs in order to give responsible leadership to his patients. Teaching of family planning in medical colleges has been a major problem for medical educators for various reasons. This difficulty has been intensified with the increase in the number of medical colleges. India is facing acute shortages of specialists and medical teachers. Coordination of an integrated approach is beset with many difficulties especially in medical curriculum. A survey conducted by Rice in 1966 showed that the medical colleges in India were assigning 5 to 6 times as many hours to the lectures discussion and demonstration on population dynamics family planning programs conception control techniques and related social cultural educational and motivational aspects as compared to an average medical school in the West. The Medical Council of India has promoted family planning teaching and services in medical colleges since 1957. A Conference of Deans and Principals of Medical Colleges was organized by the Ministry of Health Family Planning and Urban Development in August 1967 and made recommendations and suggestions on teaching family planning in medical colleges. On the recommendations of the Central Council of Health a committee has been constituted to examine the entire medical curriculum and to see whether it meets the present needs of the country as well as the modern advances in the health science.