A pyramid model of health manpower in the 1980s

In little more than a decade, the problems and issues relating to the supply of, and demand for, skilled health manpower in the United States have shifted dramatically. Where the key words in the late 1960s were "shortage," "crisis," and "expansion of training capacity," the major concerns on the threshold of the 1980s are "oversupply," "overtraining," and "costs." Federal policy relating to health manpower is rapidly changing from attempts to increase manpower supply to efforts to contain expansion. This article presents a graphic representation of this change, along with projections for the future. Three stages of supply/demand are graphically depicted: Stage I represents the supply-deficit situation of the past; Stage II symbolizes a state of supply/demand balance; and Stage III represents the oversupply situation which seems imminent in many health manpower categories. Some suggestions for possible actions to prevent unlimited "might makes right" solutions to oversupply problems, and assessments of the results which might be expected, are presented.