Douglass A B, Hinz C F
Family Practice Residency Program, Middlesex Hospital, Middletown, CT 06457, USA.
Am J Med. 1995 Apr;98(4):399-405. doi: 10.1016/s0002-9343(99)80320-9.
Physician supply planning has become an issue of increasing national debate over the past decade, particularly with the recent focus on health care reform. Most authorities agree that the United States has an increasing surplus of physicians.
The physician supply debate focuses on how to determine current and future physician supply and define appropriate specialty mix needs and then choose the measures that will appropriately influence the current and future size and specialty mix of the physician workforce. We examine these issues in the context of internal medicine in Connecticut, which may provide a single-state model for physician supply planning.
Data on the past and current supply of Connecticut internists and projections for future supply and need are examined. Particular attention is given to adult primary care (provided largely by general internists) and public policy implications.
We find Connecticut has a disproportionate number of internists compared with the nation. Further, internist supply is growing faster than the population. Almost all subspecialties are in surplus and projected to increase further by the year 2000.
Several approaches are available to limit excesses and produce more primary care physicians, including controls on residency and fellowship positions. Each approach presents both opportunities and challenges, and their implications must be carefully considered.
在过去十年中，医生供应规划已成为全国范围内争论日益激烈的一个问题，尤其是在近期聚焦于医疗保健改革的情况下。大多数权威人士都认为，美国医生过剩的情况日益严重。
医生供应问题的争论焦点在于如何确定当前和未来的医生供应量，界定适当的专科组合需求，然后选择能够适当影响当前和未来医生劳动力规模及专科组合的措施。我们在康涅狄格州内科的背景下研究这些问题，该州或许能为医生供应规划提供一个单州模式。
研究了康涅狄格州内科医生过去和当前的供应数据以及未来供应和需求的预测。特别关注成人初级保健（主要由普通内科医生提供）及公共政策影响。
我们发现，与全国相比，康涅狄格州的内科医生数量不成比例。此外，内科医生供应量的增长速度快于人口增长速度。几乎所有亚专科都供过于求，预计到2000年还会进一步增加。
有几种方法可用于限制过剩并培养更多初级保健医生，包括控制住院医师和专科医师培训名额。每种方法都既带来机遇也带来挑战，必须仔细考虑它们的影响。
