The generalist health care workforce: issues and goals

Area of Science:

• Health Services Research
• Medical Education
• Healthcare Workforce Policy

Background:

• The generalist health care workforce, primarily delivering primary care, includes family physicians, internists, pediatricians, nurse practitioners, and physician assistants.
• Factors such as healthcare needs, managed care practices, international comparisons, and costs highlight the compelling need to increase generalist providers.
• Current projections indicate a worsening shortfall of generalists without significant intervention.

Purpose of the Study:

• To address the projected shortfall of generalist healthcare providers in the United States.
• To explore strategies for increasing the proportion and supply of generalist physicians.
• To identify key issues for healthcare reform to meet national primary care needs.

Main Methods:

• Analysis of factors influencing the generalist workforce, including healthcare needs and cost-effectiveness.
• Evaluation of the timeline for medical student career changes to impact generalism.
• Consideration of retraining specialist physicians as a short-term solution.

Main Results:

• Significant increases in generalist providers are needed, but changing medical student choices will take over 20 years for impact.
• Retraining specialist physicians in oversupply presents a viable short-term option to address the generalist deficit.
• Healthcare reform must address system integration, specialist retraining models, and medical education changes.

Conclusions:

• A multi-faceted approach is required, including integrating generalist disciplines, developing specialist-to-generalist retraining programs, and reforming medical education.
• Addressing the generalist workforce shortage is critical for meeting the nation's primary care needs.
• Policy changes are essential to ensure an adequate and well-trained generalist health care workforce.