Medical Staff

Editorial: Better care, not more physicians

Medical Staff Leader Insider, July 12, 2006

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An analysis of physician labor inputs across regions with an academic medical center projects a surplus of nearly 50,000 physicians by the year 2020, based on regions with the lowest number of doctors per capita. The study's lead author, David Goodman, a professor of pediatrics and family medicine at Dartmouth Medical School, cites data from patient and physician surveys to argue that increasing the number of physicians does not improve health or patient satisfaction.

Although the Association of American Medical Colleges has called for a 15% increase in U.S. medical school enrollment to meet the needs of the booming over-65 population, regions with fewer physcians per capita provide more efficient care, according to the study published in the March-April issue of Health Affairs.   

Goodman argues that adding more physicians to the workforce is "like prescribing more drugs for an already overmedicated patient, [and] may only make things worse," in a July 10 editorial published in the New York Times.

"By training more doctors than we need, we will continue to fill more hospital beds, order more diagnostic tests -- in short, spend more money. But our resources would be better directed toward improving efforts to prevent illness and manage chronic ailments like diabetes and heart disease," Goodman writes in the Times.

"Better coordination of care is also worth investment. Small physician groups in disconnected offices often provide fragmented treatments, while multispecialty practices integrated with hospitals -- prevalent in Minneapolis and some other cities -- are associated with lower cost and higher quality of care."

Sources:

"End-of-Life Care at Academic Medical Centers: Implications for Future Workforce Requirements," Health Affairs, 25, no. 2 (2006): 521-531.

"Too Many Doctors in the House," New York Times, July 10, 2006.

 



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