Salsberg Edward, Grover Atul
AAMC Center for Workforce Studies, Association of American Medical Colleges, Washington, DC, USA.
Acad Med. 2006 Sep;81(9):782-7. doi: 10.1097/00001888-200609000-00003.
A physician shortage is likely given current levels of medical education and training. Because an increase in physician supply through expansion of U.S. medical school capacity will require ten or more years, there is little time left to affect the supply of new physicians in 2020 when a substantial number of baby boomers will be over 70 years of age. Even with a substantial increase in medical education and training capacity, it is unlikely that all of the increased demand for health services can be met with physicians. In addition to the challenges of expanding medical school enrollment, the nation will need to grapple with other ramifications of demand exceeding supply. This includes assessing how to deliver services more effectively and efficiently and the future roles of the physician and other health professionals. These challenges are particularly difficult for medical schools and teaching hospitals, the cornerstones of medical education and training in the United States. Osteopathic and off-shore schools targeted to Americans have been willing and able to grow more quickly and less expensively than U.S. medical schools, in part because of their more narrow approaches to medical education. In addition, physicians from less developed countries continue to migrate to the United States in significant numbers. Medical schools, teaching hospitals, and policymakers will need to address several major questions as they respond to the shortages. They will either confront and address these issues in the next few years or they will be forced to change by others in the future.
鉴于当前医学教育和培训的水平，医生短缺问题可能会出现。由于通过扩大美国医学院校规模来增加医生供应需要十年或更长时间，到2020年，当大量婴儿潮一代年满70岁以上时，几乎没有时间来影响新医生的供应了。即使大幅增加医学教育和培训能力，也不太可能让医生满足所有增加的医疗服务需求。除了扩大医学院校招生人数面临的挑战外，国家还需要应对需求超过供应带来的其他影响。这包括评估如何更有效率地提供服务以及医生和其他医疗专业人员未来的角色。这些挑战对医学院校和教学医院来说尤其困难，而它们是美国医学教育和培训的基石。面向美国人的整骨医学院和海外医学院，愿意且有能力比美国医学院校发展得更快、成本更低，部分原因是它们的医学教育方式更为单一。此外，来自欠发达国家的医生仍大量移民到美国。医学院校、教学医院和政策制定者在应对短缺问题时需要解决几个主要问题。他们要么在未来几年直面并解决这些问题，要么未来会被迫被他人改变。
