A surplus of physicians? The view of internists at a single institution.

Autor:	Balcezak TJ; Yale University School of Medicine, New Haven, USA., Getnick GS, Cadman EC
Jazyk:	angličtina
Zdroj:	Connecticut medicine [Conn Med] 1999 Dec; Vol. 63 (12), pp. 723-8.
Abstrakt:	Background: The sizable increase in the United States physician workforce over the last 25 years has led to a concern by health policy analysts that we are training too few generalist physicians, too many specialists and too many doctors altogether. Nearly all analysts' studies report that the United States currently has an adequate or more than adequate supply of physicians; however, few reports discuss practicing physicians' view of the issues. Objective: To determine internists' opinion regarding the current and future physician supply and specialty mix. Design: Analysis of results of a mailed questionnaire. Setting: Nine hundred bed academic medical center in southern Connecticut. Participants: Three hundred seventy eight internal medicine attendings, fellows and residents. Measures: Seventeen questions that covered 4 domains: is there or will there be a surplus of general internists, internal medicine subspecialists or total physicians in Connecticut or the United States; which internal medicine subspecialties have a current surplus; what is the correct primary care/specialty care mix for our physician workforce; and what subspecialties are current internal medicine residents planning to pursue? Results: A total of 378 of 686 (55%) mailed surveys were returned. The majority of physicians reported that there is currently no surplus of physicians (68%) or general internists (90%) in the Unites States, but that there is a surplus of internal medicine subspecialists (68%). The majority of the physicians who responded that there is no current surplus reported that there would not be a surplus in 10 years. Subspecialties most frequently indicated to have a surplus in the United States were cardiology (70%) and gastroenterology (57%). A majority of internal medicine residents (66%) indicated that they planned to pursue subspecialty fellowship; the fellowship most commonly indicated was cardiology (23%). Conclusions: In contrast to the opinion of most health policy analysts, the majority of internists associated with our institution do not believe that there is or will be a physician surplus in the United States. Reasons for a difference of opinion between practicing internists and health policy analysts are worthy of further study.
Databáze:	MEDLINE
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