05551nam 2200637Ia 450 991081716970332120240416233727.00-309-17589-51-280-19216-X97866101921680-309-58890-10-585-00183-9(CKB)110986584751750(SSID)ssj0000208451(PQKBManifestationID)11175441(PQKBTitleCode)TC0000208451(PQKBWorkID)10240023(PQKB)11056473(MiAaPQ)EBC3376307(Au-PeEL)EBL3376307(CaPaEBR)ebr10055407(CaONFJC)MIL19216(OCoLC)923262779(EXLCZ)9911098658475175019960313d1996 uy 0engurcn|||||||||txtccrThe nation's physician workforce options for balancing supply and requirements /Committee on the U.S. Physician Supply ; Kathleen N. Lohr, Neal A. Vanselow, and Don E. Detmer, editors1st ed.Washington, D.C. National Academy Press1996xii, 109 p. illBibliographic Level Mode of Issuance: Monograph0-309-05431-1 Includes bibliographical references.The Nation's Physician Workforce: Options for Balancing Supply and Requirements -- Copyright -- Preface -- Acknowledgments -- Contents -- The Nation's Physician Workforce: Options for Balancing Supply and Requirements -- Summary -- U.S. PHYSICIAN SUPPLY AND REQUIREMENTS -- RELATIONSHIP OF PHYSICIAN SUPPLY TO KEY ELEMENTS OF THE HEALTH CARE SYSTEM -- STRATEGIES FOR ADDRESSING PHYSICIAN SUPPLY ISSUES -- Producing Physicians from U.S. Medical Schools -- Revamping Graduate Medical Training -- Controlling IMG Numbers through GME -- Replacement Funding for IMG-Dependent Hospitals -- Data Collection and Information Dissemination -- CONCLUDING STATEMENT -- 1 Introduction -- THE PHYSICIAN WORKFORCE -- THE MATCH-OR MISMATCH-BETWEEN SUPPLY AND REQUIREMENTS -- ORIGINS AND ORGANIZATION OF THE STUDY -- Charge to the Committee and Project Activities -- Related Issues -- Principles Underlying Committee Conclusions and Recommendations -- ORGANIZATION OF THIS REPORT -- 2 U.S. Physician Supply and Requirements: Match or Mismatch? -- PHYSICIAN WORKFORCE ISSUES SINCE WORLD WAR II -- General Issues -- Pre-1980s Era -- Current Status -- Physician Workforce Trends -- Overall Trends in Supply -- Trends in Graduate Medical Education -- METHODS OF ESTIMATING PHYSICIAN SUPPLY, PRODUCTIVITY, AND REQUIREMENTS -- Physician Supply -- Physician Productivity -- Physician Requirements -- THE FUTURE REQUIREMENT FOR PHYSICIANS -- Factors That Could Increase Requirements -- Factors That Could Decrease Requirements -- Managed Care -- Use of Nonphysician Personnel -- INTERNATIONAL COMPARISONS -- MATCH OR MISMATCH? -- Conclusions of Physician Workforce Studies -- Evidence from the Marketplace -- Physician Incomes -- Other Evidence -- CONCLUSION -- NOTES -- APPENDIX -- A Brief Note on Managed Care -- 3 Relationship of Physician Supply to Key Elements of the Health Care System.HEALTH CARE EXPENDITURES -- Competition -- Physician Incomes -- Health Care Costs -- ACCESS TO CARE -- Geographic Distribution -- Specialty Distribution -- Summary Comment About Access to Care -- QUALITY OF CARE -- High Numbers of Physicians Overall -- General Effects -- Volume and Quality -- Provider and Consumer Satisfaction -- Specialist-Generalist Issues -- Education and Training -- Issues Relating to IMGs -- Costs, Quality, and Physician Supply -- Summary Comment -- OTHER ISSUES IN PRODUCTION AND UTILIZATION OF THE PHYSICIAN WORKFORCE -- Human Resources Considerations -- Opportunities for Medical Careers -- U.S. Policy and the World Output of Physicians -- Future of Academic Health Centers -- General Issues -- The Service-Training Link and IMG-Dependent Institutions -- CONCLUSION -- NOTES -- 4 Strategies for Addressing Physician Supply Issues -- DO NOTHING: THE FREE OR UNREGULATED MARKET APPROACH -- INSTITUTE CENTRAL FEDERAL REGULATION -- General Approaches to Planning and Managing Physician Supply -- Committee Views -- A CONSTRAINED MARKET APPROACH -- Antitrust Considerations -- Production of Physicians from U.S. Medical Schools -- Revamp Graduate Medical Training -- Reduce GME Positions Without Changing GME Funding -- Reduce First-Year Residency Positions and Change The Approach to GME Funding -- Disconnect Funding of Service Delivery From Physician Training -- Specific Controls on Immigration -- Central Government Regulation -- Controlling IMG Numbers Through GME -- Replacement Funding for IMG-Dependent Hospitals -- Data Collection and Information Dissemination -- CONCLUDING STATEMENT -- NOTES -- References -- APPENDIX Biographies of Committee Members.PhysiciansSupply and demandUnited StatesMedical policyUnited StatesHealth planningUnited StatesPhysiciansSupply and demandMedical policyHealth planning331.12/91362172/0973Lohr Kathleen N.1941-1610164Vanselow Neal A(Neal Arthur)1674401Detmer Don E1671476MiAaPQMiAaPQMiAaPQBOOK9910817169703321The nation's physician workforce4039165UNINA