Will the power of the marketplace produce the workforce we need?

The medical manpower market will work best as an agent for change in primary care when there is vigorous demand, a sophisticated buyer, and not too large a gap to fill--conditions that we can expect with managed care growth in U.S. urban settings in the next decade. In these circumstances, the primary care supply will adjust without the need for regulatory intervention. The most dramatic workings of the market will be in stripping from the system the excess payments for practicing subspecialist physicians. However, market forces will not quickly moderate the growing oversupply of doctors nor their maldistribution to areas of need. Focused public policy manpower interventions will be needed to correct these deficits quickly.