Physician inputs, outputs, and productivity, 1976-1986.

This paper presents trends in the aggregate practice inputs, patient care outputs, and productivity of physicians over the past decade. The rising number of physicians has not increased access (total patient contacts) for the population. Instead, it has supported more physician time and medical services per visit. Larger physician requirements attributed to declining productivity are actually the result of greater intensity of care. Physician productivity in supplying medical services has not improved over the past decade, possibly contributing to rapid fee inflation. Observed trends are not consistent with Medicare fee updates that assume productivity gains.