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The Devil Is in the Assumptions

Alvin R. Tarlov, MD

JAMA. 1995;274(19):1558-1560.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

Richard Cooper's article in this issue of JAMA titled "Perspectives on the Physician Workforce to the Year 2020" ignites controversy.¹ Cooper, extrapolating from physician staffing patterns in group- or staff-model health maintenance organizations (HMOs), forecasts the physician surplus to be trivial in the year 2000 and nonexistent by the year 2020 (his Figure 1). He proclaims that the contradiction of his forecast with the reports of the Graduate Medical Education National Advisory Committee (GMENAC) in 1981,² Weiner in 1994 and 1995,^3,4 the Council on Graduate Medical Education in 1994,⁵ and the Bureau of Health Professions of the US Department of Health and Human Services in 1995⁶ is attributable to the use of insupportable assumptions in the other studies. Cooper believes that newer data now available for US population projections, HMO staffing patterns, and physician work effort justify the assumptions he has adopted.

See also p . . . [Full Text PDF of this Article]

Author Affiliations
From The Health Institute of the New England Medical Center, Tufts University School of Medicine, and Harvard University School of Public Health, Boston, Mass.

Footnotes
Reprint requests to The Health Institute, 750 Washington St, NEMC #345, Boston, MA 02111 (Dr Tarlov).

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