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Increasing the production of generalists: a computer simulation

G S Rust1, L E Fuller

  • 1Department of Family Medicine, Morehouse School of Medicine, Atlanta.

Family Medicine
|October 1, 1994
PubMed
Summary
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Achieving the 50% generalist physician goal requires more than current interventions. Computer simulations show even aggressive strategies fall short, highlighting the need for novel approaches to boost generalist careers.

Area of Science:

  • Medical Education
  • Healthcare Workforce Planning
  • Computational Modeling

Background:

  • The Association of American Medical Colleges (AAMC) aims for 50% of US medical school graduates to become generalists.
  • Established methods to achieve this goal are lacking.

Purpose of the Study:

  • To develop and utilize a computer simulation to evaluate potential interventions for increasing the proportion of generalist physicians.
  • To assess the impact of interventions at various stages of medical education.

Main Methods:

  • A computer simulation model was created to analyze interventions.
  • Each simulated intervention aimed to improve the selection of a generalist career by 10%.

Main Results:

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  • The baseline prediction for generalist physicians from 1992 graduates was 24.1%.
  • Evaluated interventions increased generalist production to 25%-26.5%.
  • Even with sustained improvements over 3 years, the model predicted only 44.8% generalists.

    • Conclusions:

    • Computerized "what-if" analysis effectively projects specialty outcomes.
    • Substantial attrition from primary care residencies into subspecialties limits generalist numbers.
    • Family practice is efficient but insufficient alone; more impactful interventions are necessary to reach the 50% generalist target.