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Lessons for the United States

Steven A. Schroeder, MD

JAMA. 1984;252(3):373-384.

Abstract
The supply and specialty distribution of physicians in Belgium, West Germany, the Netherlands, and the United Kingdom were compared with those in the United States. The numbers of physicians per 10,000 population in 1980 was 24 (Belgium), 22.9 (West Germany), 19.1 (United States), 19.0 (the Netherlands), and 16.2 (United Kingdom). Projections for 1990 were 34 (Belgium), 32.6 (West Germany), 24.3 (United States), and 17.1 (United Kingdom). The United States and the United Kingdom produce about half as many physicians per population but have a much higher proportion (26%) of foreign physicians. The United States has a much higher ratio of specialists to generalists. Official recognition of physician oversupply exists in Belgium, which is restricting specialty training, and the Netherlands, which is reducing both medical school intake and specialty training, but not yet in West Germany. The European experience suggests that the United States' most pressing health manpower problem is an oversupply of specialists.

(JAMA 1984;252:373-384)

Author Affiliations
From the Division of General Internal Medicine, Institute for Health Policy Studies, University of California, San Francisco.

Footnotes
Reprint requests to Division of General Internal Medicine, Institute for Health Policy Studies, University of California, San Francisco, 400 Parnassus, A405, San Francisco, CA 94143 (Dr Schroeder).

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