Schwartz W B, Williams A P, Newhouse J P, Witsberger C
Department of Medicine, Tufts University School of Medicine, Boston, MA 02111.
JAMA. 1988 Jan 8;259(2):233-9.
As of 1983, 10% to 40% of cities with a population of 200,000 to 500,000 lacked a board-certified physician in one or more medical subspecialties, and many additional cities of this size had only one certified representative in many of the subspecialties. Somewhat smaller cities (population, 125,000 to 200,000) had far less complete coverage. Even when one includes board-certified internists who declared themselves subspecialists but lacked certification, there were many relatively large cities without complete coverage. Between now and 2000, an appreciable portion of the projected larger pool of board-certified subspecialists will be required to deal with a growing population and an increase in per capita demand for care. Others will locate in underserved or underserved cities, but our data suggest that even in 2000, many relatively large cities will have a deficit of most types of subspecialists.
截至1983年，在人口为20万至50万的城市中，10%至40%的城市缺少一名或多名医学亚专科的委员会认证医师，而且许多这种规模的其他城市在许多亚专科中仅有一名认证代表。规模稍小的城市（人口12.5万至20万）的覆盖范围则远远不够完整。即使将那些自称是亚专科医师但未获得认证的委员会认证内科医师包括在内，仍有许多较大城市的覆盖范围不完整。从现在到2000年，预计数量会大幅增加的委员会认证亚专科医师中，将需要有相当一部分来应对不断增长的人口以及人均医疗需求的增加。其他医师会前往服务不足或未得到充分服务的城市，但我们的数据表明，即使到2000年，许多较大城市的大多数亚专科医师仍将短缺。
