Understanding the persistence of human resource problems in health

Four current and central problems in health manpower--total numbers, geographic distribution, field of practice, and productivity--are analyzed in the light of the recommendations of the Committee on the Costs of Medical Care. The persistence of these problems since 1932 is due to limited mobility within health occupations, and other differential controls of human resources. Efforts to correct manpower imbalances through educational solutions ignore the role of educational institutions in perpetuating social inequality. Traditional patterns are challenged in an exploration of new sources of change.