Berg Alfred O, Norris Thomas E
Department of Family Medicine, School of Medicine, University of Washington, Seattle, Wash 98195, USA.
Ann Fam Med. 2006 Sep-Oct;4 Suppl 1(Suppl 1):S40-4; discussion S58-60. doi: 10.1370/afm.523.
This case study describes the findings of a physician workforce analysis and how an institution is using these findings to address the decreasing proportion of medical students choosing primary care careers.
A University of Washington School of Medicine committee commissioned an analysis of the American Medical Association Physician Masterfile. The analysis examined physician-to-population ratios, rural-urban geographic distribution, physician demographics, and physician graduation from the university or one of its affiliated residency programs for graduates of allopathic medical schools and residencies at the county level in the 5 states in the WWAMI partnership (Washington, Wyoming, Alaska, Montana, and Idaho).
The analysis found that in 2005, the 5 WWAMI states ranked at the bottom of US states in the number of publicly supported medical school and residency slots per capita. Although physician-to-population ratios were comparable to those in the rest of the country, the 5 WWAMI states imported most of their physicians, including family physicians, approximately 70% of whom came from other medical schools or residency programs. Family physicians were the only specialty distributed across the population gradient from urban to isolated rural areas. The workforce analysis is informing planning for medical school expansion, admissions, support for primary care, curriculum, and research at an institution with a clear mission that includes training the health workforce for its region.
The analysis has wide potential applicability, but it has special relevance for primary care and has been particularly useful in making the case for supporting primary care education in the WWAMI region.
本案例研究描述了一项医生劳动力分析的结果,以及一所机构如何利用这些结果来应对选择初级保健职业的医学生比例下降的问题。
华盛顿大学医学院委员会委托对美国医学协会医生主文件进行分析。该分析考察了医生与人口的比例、城乡地理分布、医生人口统计学特征,以及在WWAMI合作项目(华盛顿州、怀俄明州、阿拉斯加州、蒙大拿州和爱达荷州)的5个州中,县级全科医学医学院毕业生和住院医师从该大学或其附属住院医师项目毕业的情况。
分析发现,2005年,WWAMI的5个州在人均公共支持的医学院和住院医师名额数量方面在美国各州中排名垫底。尽管医生与人口的比例与美国其他地区相当,但WWAMI的5个州的大多数医生,包括家庭医生,约70%来自其他医学院或住院医师项目。家庭医生是唯一一种分布在从城市到偏远农村地区人口梯度上的专业。劳动力分析为一所有着明确使命(包括为其所在地区培养卫生人力)的机构在医学院扩张、招生、初级保健支持、课程设置和研究规划方面提供了信息。
该分析具有广泛的潜在适用性,但对初级保健具有特殊意义,并且在为支持WWAMI地区的初级保健教育提供依据方面特别有用。