AAMC President Says Many Factors Must Be Considered In Assessing The U.S. Physician Supply

Main Category: Primary Care / General Practice
Article Date: 11 Jun 2008 - 15:00 PDT

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In a new Journal of the American Medical Association commentary published recently, AAMC (Association of American Medical Colleges) President and CEO Darrell G. Kirch, M.D., says addressing the complex issue of physician workforce supply requires a thorough analysis of as many influencing factors as possible.

The commentary notes that the current debate over the projected physician shortage concentrates on a single variable affecting supply or demand, resulting in policy recommendations based on change to only one of several interrelated factors at play in physician supply dynamics.

Dr. Kirch and David Vernon, AAMC research fellow, cite as an example a 2002 analysis that focused solely on the factor of national economic output. The researchers assumed a historic correlation existed between economic growth and the use of health services that is essentially fixed, which "led the authors to urge that production of physicians by medical schools and residency programs be significantly increased to keep pace with economic growth."

Countering this conclusion by focusing on a different factor-reorganization of the health care financing delivery system-a 2008 analysis by different researchers asserted that reorganizing health care financing systems should take precedence over investment in the growth of U.S. medical school enrollment. The analysis found a positive correlation between higher levels of health care spending and greater numbers of medical specialists. According to Dr. Kirch, however, the authors make a "significant leap" by going beyond their correlation to conclude that variations in health care costs should be resolved by restricting the supply of physicians.

Instead of using a single variable, Dr. Kirch and Mr. Vernon believe that, "'solving' the physician workforce equation requires analyzing as many key variables as possible" that affect physician supply and demand. The complex variables affecting physician supply they cite include physician retirement patterns, generational and gender differences in work patterns, medical school enrollment, and international medical graduate importation. Physician demand may be affected by insurance coverage and reimbursement reforms, changes in the health care delivery system, and the aging and health care use patterns of the population. Some factors, such as generational differences in work patterns and changes in the health care delivery system, are difficult to quantify.

Dr. Kirch and Mr. Vernon point out that while the AAMC's Center for Workforce Studies has begun to explore the complex factors affecting physician supply and demand, "one organization cannot do it alone," and call on other groups to do more. "What cannot be argued is the importance of establishing an effort to attain a much better understanding of future national health care workforce needs."

To read the JAMA commentary, "Confronting the Complexity of the Physician Workforce Equation," go here.

The Association of American Medical Colleges is a not-for-profit association representing all 129 accredited U.S. and 17 accredited Canadian medical schools; nearly 400 major teaching hospitals and health systems, including 68 Department of Veterans Affairs medical centers; and 94 academic and scientific societies. Through these institutions and organizations, the AAMC represents 109,000 faculty members, 67,000 medical students, and 104,000 resident physicians. Additional information about the AAMC and U.S. medical schools and teaching hospitals is available at http://www.aamc.org/newsroom.

Association of American Medical Colleges