LEADER 05551nam 2200637Ia 450 001 9910817169703321 005 20240416233727.0 010 $a0-309-17589-5 010 $a1-280-19216-X 010 $a9786610192168 010 $a0-309-58890-1 010 $a0-585-00183-9 035 $a(CKB)110986584751750 035 $a(SSID)ssj0000208451 035 $a(PQKBManifestationID)11175441 035 $a(PQKBTitleCode)TC0000208451 035 $a(PQKBWorkID)10240023 035 $a(PQKB)11056473 035 $a(MiAaPQ)EBC3376307 035 $a(Au-PeEL)EBL3376307 035 $a(CaPaEBR)ebr10055407 035 $a(CaONFJC)MIL19216 035 $a(OCoLC)923262779 035 $a(EXLCZ)99110986584751750 100 $a19960313d1996 uy 0 101 0 $aeng 135 $aurcn||||||||| 181 $ctxt 182 $cc 183 $acr 200 14$aThe nation's physician workforce $eoptions for balancing supply and requirements /$fCommittee on the U.S. Physician Supply ; Kathleen N. Lohr, Neal A. Vanselow, and Don E. Detmer, editors 205 $a1st ed. 210 $aWashington, D.C. $cNational Academy Press$d1996 215 $axii, 109 p. $cill 300 $aBibliographic Level Mode of Issuance: Monograph 311 $a0-309-05431-1 320 $aIncludes bibliographical references. 327 $aThe 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. 327 $aHEALTH 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. 606 $aPhysicians$xSupply and demand$zUnited States 606 $aMedical policy$zUnited States 606 $aHealth planning$zUnited States 615 0$aPhysicians$xSupply and demand 615 0$aMedical policy 615 0$aHealth planning 676 $a331.12/91362172/0973 701 $aLohr$b Kathleen N.$f1941-$01610164 701 $aVanselow$b Neal A$g(Neal Arthur)$01674401 701 $aDetmer$b Don E$01671476 801 0$bMiAaPQ 801 1$bMiAaPQ 801 2$bMiAaPQ 906 $aBOOK 912 $a9910817169703321 996 $aThe nation's physician workforce$94039165 997 $aUNINA