Projections of physician supply and demand: a summary of HRSA and AMA studies

There is concern that the United States may have a surplus of physicians soon. In a continuation of a movement started around 1980 by the Graduate Medical Education National Advisory Committee (GMENAC) to quantify and project supply and demand for physicians, the American Medical Association (AMA) and the Health Resources and Services Administration (HRSA) have recently produced their latest studies on this subject. The HRSA conclusion, published in its 1988 report to the President and Congress on the status of health personnel in the United States, is that a surplus may come as early as 1990 and will probably worsen by the year 2000. The AMA study, also published in 1988, agrees with the HRSA and the GMENAC that supply will probably grow faster than demand, but it disclaims the notion of a surplus or shortage because that would imply judgments about the adequacy of current utilization rates by all segments of the population. The HRSA report cites a 1986 finding by the Robert Wood Johnson Foundation that access to medical care deteriorated between 1982 and 1986 for minorities and lower-income groups. On the supply side, the HRSA's estimates are somewhat higher than the AMA's, mainly because the former assumes faster growth in foreign medical graduates. Both studies use a demand-based approach to projecting the number of physicians required, but there are considerable differences in the assumptions made about future utilization rates.