Oopsie! The physician and nurses shortage was manufactured.

Cerridwen

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Sun Jan-25-09 08:13 PM
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Oopsie! The physician and nurses shortage was manufactured.

The physician and nurses shortage was manufactured based on erroneous predictions. Damn! Don't you hate when that happens?

I actually posted about this in July of 2007. A couple of the links I used in that original post have now gone missing. Here is some of the updated information and the links to read the full story.

The cited articles focus on physicians. Other reports to which these snips refer, included nurses, dentists and other health care providers and schools.

From "Critical Challenges: Revitalizing the Health Professions for the Twenty-First Century" one of the reports used to come to the following conclusions:

CHALLENGE 3: Right-sizing the health professional workforce and the institutions that produce health professionals. For the most part this will mean reducing the size of the professions and programs.

<snip>

D2: By 2005 reduce the size of the entering medical school class in the U.S. by 20-25%. This would mean a reduction from the 1995 class of 17,500 to an entering class size of 13,000 to 14,000 for 2005. This reduction should come from closing medical schools, not reducing class size.

<snip>

E4: Reduce the size and number of nursing education programs (1,470 basic nursing programs as of 1990) by 10-20%. These closings should come in associate and diploma degree programs. These closings should pay attention to the reality that many areas have a shortage of educational programs and many more have a surplus.

E5: Encourage the expansion of the number of masters level nurse practitioner training programs by increasing the level of federal support for students.

<Four paragraph limit and snip. You can't get the full picture from just these snips.>

Much more at link.

In the 1980s and 1990s, workforce analysts and public policymakers, with few exceptions, predicted the
United States would experience a substantial excess of physicians by the beginning of the 21st century.
In light of these studies, the AAMC and other national organizations recommended steps to reduce
physician supply in order to obviate the predicted surplus. Over the past two decades, enrollment at
allopathic medical schools has been essentially flat.

It is now evident that those predictions were in error, in part because of the assumption that managed
care would drastically change the way that healthcare is organized, and delivered. The year 2000 has
come and gone, and there is no convincing evidence that the current supply of physicians exceeds the
demand for physicians’ services. Mounting analytical work, as well as anecdotal evidence, suggests that
current trends will culminate in a shortage of physicians within the next few decades, absent
fundamental changes in the demand and need for healthcare and/or in the way healthcare is provided.
Indeed, there have been a growing number of specialty and state specific studies concluding that
shortages exist or will soon exist in particular specialties or states.

{Note: the following links to a .pdf document} From a report by the American Association of Medical Colleges, AAMC Statement on the Physician Workforce.

A report on the chronology of predicting a surplus and the difficulty of reversing the course to address the shortages. {Note: links to a .pdf document from The American Academy of Pediatrics}

* GMENAC’s recommendations were then to be used as a basis for federal policy
to modify and control the numbers and kinds of GME training positions made
available through federal funding.
* There will be too many physicians in 1990.
* Reduce medical school class size by 10% by 1984.

<snip>

Consensus Statement on the Physician Workforce (1997)
* Noted a serious oversupply of physicians.

<snip>

Cooper, et al. (2002)

* Trend analysis approach used by Cooper rejected by many leading health
workforce researchers.
* Yet, this study served as the methodological basis for later workforce studies.

<snip>

AAMC Workforce Policy (2003-5)
* In 2003, the AAMC rescinded its prediction of a physician surplus, because it
said it was undecided.
* In 2005, the AAMC again changed its position by stating that there was an
impending physician shortage.
* To address this shortage, it recommended both a 15% increase in medical
school class sizes and a 15% increase in the number of US medical schools.

<snip. Not sure about four paragraph rule as applies to bullet point outlines.>

{Note: yep, another .pdf More complete picture at link

Medical Schools Are Urged To Cut Admissions by 20%

By ESTHER B. FEIN
Published: November 17, 1995

In a move that would radically change the system of training doctors in this country, a panel of national health care experts called yesterday for slashing the number of medical school slots by 20 to 25 percent over the next 10 years, asserting that there is an oversupply of doctors that contributes to the inefficiency of medical care.

The recommendation by the Pew Health Professions Commission comes with an added sting -- the proposal that these cuts be achieved by closing entire schools and training programs, an echo of the closing of military bases. Any such closings are sure to face opposition in communities that are economically dependent on medical schools.

<snip to New York Times article

I wonder what would happen if there were too many health care providers? What is a good provider/patient ratio? Would prices drop? Competition increase? Incompetence be removed? Incompetence increase? Would a surplus of providers mean travelling the world? Would a surplus be bad in a non-market driven system? Seriously, I'm asking.