More physicians are not the answer

The Association of American Medical Colleges has called for an increase of 30% in matriculation in United States medical schools to treat the growing number of elderly patients with chronic illnesses. However, increasing the physician supply is unlikely to address the underlying problem, that being the growth of chronic disease, which necessitates a shift in orientation from treatment to management and prevention. This shift will in turn require a change in the makeup of health care providers. Instead of more physicians, more nonphysician professionals must be trained so as to aggressively coordinate comprehensive chronic disease care. A disease management model led by physicians, but including advanced practice nurses and other professionals, offers the opportunity to enhance efficiency, improve quality, reduce hospitalization, and meet evidence-based mandates. Such a workforce transition can become the inaugural step in converting the entire health care system from treatment based to prevention and management based. In conclusion, the position of the Association of American Medical Colleges should be a platform for discussion.