Does Having More Physicians Lead to Better Health System Performance?
- David C. Goodman, MD, MS;
- Kevin Grumbach, MD
- Author Affiliations: Center for Health Policy Research, Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth Medical School, Hanover, New Hampshire (Dr Goodman); Department of Family and Community Medicine, University of California, San Francisco (Dr Grumbach).
- Corresponding Author: Kevin Grumbach, MD, Department of Family and Community Medicine, San Francisco General Hospital, 1001 Potrero Ave, San Francisco, CA 94110 (kgrumbach{at}fcm.ucsf.edu).
Since this article does not have an abstract, we have provided the first 150 words of the full text.
- KEYWORDS:
- DELIVERY OF HEALTH CARE
- EDUCATION, MEDICAL
- HEALTH MANPOWER
- HEALTH POLICY
- HEALTH SERVICES ACCESSIBILITY
- PHYSICIANS
- QUALITY OF HEALTH CARE
- TRAINING SUPPORT
The US health system faces ongoing challenges in addressing its shortcomings in access and quality.1 Against a foreground of uneven and fragmented care lies a bleak background of unrelentingly accelerating costs. Although the problems of quality and costs are long-standing, several organizations have recently asserted that there is a new impending health care “tragedy”2: the physician workforce shortage. In contrast to the extensively documented problems of quality and affordability, the inference of a physician shortage rests on a less robust set of analyses. Assertions of a physician shortage warrant a critical examination because more physicians will compete for new resources against already well-documented health system needs.
From Surplus to Shortage
Ten years ago, the consensus was that there were too many physicians, particularly specialists, in the United States. In the 1990s, the Council on Graduate Medical Education (COGME) promoted policies to reduce the overall number of residency training positions while shifting …
