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Health manpower: numbers, distribution, quality.

Annals of Internal Medicine

|May 1, 1975

Summary

Increasing physician numbers alone did not solve the healthcare crisis. Key issues include geographic maldistribution and overproduction of specialists, necessitating more primary care physicians.

Area of Science:

Medical Education
Health Policy
Physician Workforce Studies

Background:

The prevailing notion that increasing physician numbers would resolve the healthcare crisis has proven insufficient.
Significant challenges in physician distribution include geographic disparities, with shortages in rural and inner-city areas, alongside an oversupply of specialists.

Purpose of the Study:

To analyze the factors contributing to geographic and specialty maldistribution of physicians.
To examine the influence of undergraduate and postgraduate medical education on physician distribution.
To evaluate the role of specialty boards in shaping career choices and health manpower.

Main Methods:

Analysis of changes in medical education curricula.
Review of data on physician specialization trends.

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Examination of the impact of specialty board requirements on career paths.

Main Results:

Evidence indicates an overproduction of surgeons and subspecialists like cardiologists.
Graduate training programs are identified as major contributors to excess subspecialization.
Medical education reforms have inadvertently exacerbated maldistribution issues.

Conclusions:

Addressing the healthcare crisis requires tackling geographic and specialty maldistribution.
There is a critical need for increased numbers of primary care physicians, including general internists, family physicians, and pediatricians.
Reforming medical education and specialty board roles is essential for better physician distribution.