GAO-02-137R Supply of Selected Health Workers

United States General Accounting Office

Washington, DC 20548

October 10, 2001

The Honorable W.J. “Billy” Tauzin

Chairman

Committee on Energy and Commerce

House of Representatives

Subject: Health Care: Adequacy of Pharmacy, Laboratory, and Radiology Workforce

 Supply Difficult to Determine

Dear Mr. Chairman:

Concern is growing about the supply of health care workers for meeting current

demand as well as the future needs of an aging population. Emerging shortages of

both nurses and nurse aides, the two largest categories of health care workers, have

recently been the subject of several congressional hearings and numerous media

reports.1

 Now some health care providers and professional organizations also are

beginning to report difficulty recruiting sufficient numbers of pharmacists and

laboratory and radiologic technologists and technicians. In response to these

concerns, you asked us to describe the current and projected supply and demand for

pharmacists and laboratory and radiology workers and trends in their employment

and earnings. In this correspondence, we provide information on (1) current

workforce trends for pharmacists, (2) current workforce trends among laboratory

and radiologic technologists and technicians, and (3) factors that may affect the

supply and demand for these workers in the future.

To provide this information, we relied primarily on published reports and data from

the Department of Labor’s Bureau of Labor Statistics (BLS) and the Department of

Health and Human Services’ Health Resources and Services Administration (HRSA).

While BLS data on earnings for these occupations were available through 2000,

reliable data on total employment were available only through 1998. We also

obtained data from professional associations representing the various disciplines and

from provider and employer organizations. We reviewed the relevant professional

and research literature and interviewed industry and professional association

representatives, researchers, and other experts. We performed our work during

September 2001 in accordance with generally accepted government auditing

standards.

 1

A list of related GAO products is in the enclosure.
2 GAO-02-137R Supply of Selected Health Workers

In summary, while the number of pharmacists has grown over the past decade, there

is evidence of increasing demand for pharmacy services, which, according to HRSA

and others, is outpacing the growth in supply. Earnings for pharmacists have risen

significantly in recent years, and employers and professional associations are

reporting increased vacancy rates and difficulties in hiring. Key factors that may be

contributing to greater demand include an increase in the number of prescriptions

filled, growth in the number and hours of retail pharmacy outlets, and an expansion

of pharmacists’ roles. While demand has continued to increase in recent years, the

number of pharmacy school graduates has declined.

Higher vacancy rates and declining numbers of new entrants to the laboratory and

radiologic fields have been reported by provider and professional associations.

However, employment and earnings data for laboratory and radiologic technologists

and technicians do not produce a clear picture about the current balance of supply

and demand for these workers. While total employment for these workers grew from

1988 to 1998, reliable data to describe more recent trends are not available. Although

significant growth in wages has been reported for segments of the laboratory

workforce, overall earnings growth for both laboratory and radiologic technologists

and technicians has lagged behind the rate of earnings growth for all workers from

1998 to 2000.

Demographic changes, technological advances, and management decisions on how

both staff and technology are utilized will affect the demand for workers in the

future. Population changes associated with the aging of the baby boom generation

can be expected to increase the demand for pharmacy, laboratory, and radiology

services and to limit the supply of workers available to provide them. However, the

impact of scientific and technological advances is difficult to predict. Improvements

in some technologies may raise the productivity of the existing workforce, but other

advances in science may increase the volume and complexity of health care services

and create a need for additional workers with more sophisticated skills. The demand

for workers also may be affected by management decisions on how to employ

technology and how to use workers with differing skills and qualifications.

BACKGROUND

After nurses, nurse aides, and physicians, three of the largest groups of health care

workers are pharmacists, laboratory technologists and technicians, and radiologic

technologists and technicians. Pharmacists are licensed by state pharmacy boards to

prepare and dispense drugs. They also may educate patients about medications,

monitor patients’ responses to medications, and track adverse drug reactions and

interactions. Currently, most pharmacy students are enrolled in a 6-year program of

postsecondary education leading to a doctor of pharmacy degree.2 In 1998, BLS

 2

Currently, there are two degree programs eligible for accreditation by the American Council of

Pharmaceutical Education: Bachelor of Science in Pharmacy, a 5-year program, and Doctor of

Pharmacy. After 2003, only the 6-year Doctor of Pharmacy program will be eligible for accreditation.
3 GAO-02-137R Supply of Selected Health Workers

reported that there were approximately 185,000 pharmacists employed in the United

States, with median annual earnings of $66,227.3 Of these pharmacists, 25 percent

worked in hospitals; 59 percent worked in retail settings, such as chain drug stores

and grocery stores; and the remaining 16 percent worked in other settings, such as

nursing homes and pharmacy schools.

Laboratory technologists and technicians, often referred to as clinical or medical

technologists and technicians, perform a variety of diagnostic tests on blood and

tissue samples.4 They may specialize in specific branches of laboratory science, such

as cytology (the study of cells and cell abnormalities), histology (the study of tissue

structure and organization), microbiology, or immunology. Also included are

phlebotomists, who collect blood samples for testing or blood donations for blood

banks. Training for technologists typically consists of a 4-year baccalaureate degree

program. Educational preparation for technicians may consist of an associate’s

degree from a community college; a certificate from a hospital, vocational school, or

the armed forces; or on-the-job training. Eleven states require licensing of laboratory

technologists, and most technologists are certified by a professional association.5

BLS reported that there were approximately 313,000 employed laboratory

technologists and technicians in 1998, with median annual earnings of $37,274 for

technologists and $26,291 for technicians. Forty-nine percent of laboratory

technologists and technicians were employed in hospitals in 1998, 20 percent in

physicians’ offices, 14 percent in medical or dental laboratories, and the remaining 17

percent primarily in government, research, and educational settings.

Radiologic technologists and technicians perform a variety of diagnostic imaging

procedures such as X-rays, magnetic resonance imaging (MRI), computer assisted

tomography (CT) scans, sonograms, and mammograms. As with training for

laboratory workers, training for radiologic technologists and technicians varies.

Although 2-year training programs are most common for technologists, educational

preparation for technologists and technicians can range from 1 to 4 years and lead to

a certificate or an associate’s or bachelor’s degree. Most radiologic technologists are

certified, and 34 states require licensure for these workers.6 According to BLS, there

were approximately 162,000 radiologic technologists and technicians employed in

1998, with median annual earnings of $32,885. Sixty percent were employed in

 3

1998 is the last year for which we have BLS data on both employment and earnings for pharmacists,

laboratory workers, and radiology workers. Data on total employment for 2000 will be available from

BLS’ Office of Employment Projections in November 2001.

4

Technologists, both laboratory and radiologic, typically have a higher level of training and expertise

than technicians.

5

The American Society of Clinical Pathologists’ Board of Registry is the primary organization for the

voluntary certification of professionals in laboratory medicine.

6

The American Registry of Radiologic Technologists is the primary organization for the voluntary

certification of radiologic technologists.
4 GAO-02-137R Supply of Selected Health Workers

hospitals, 30 percent in physicians’ offices, 6 percent in medical and dental

laboratories, and the remaining 4 percent in various other settings.

PHARMACY WORKFORCE PRESSURES

REFLECT GROWING DEMAND

While the number of active pharmacists has grown steadily since 1991, demand for

pharmacist services is increasing and, according to HRSA and others, may be

outpacing the growth of supply. Several provider and professional associations are

reporting higher vacancy rates for pharmacists and increasing difficulties in hiring.

At the same time, earnings for pharmacists have grown significantly, rising 17 percent

from 1998 to 2000. The current pressures affecting the pharmacist workforce appear

to be the product of an increased demand for pharmacy services and a declining

number of graduates from schools of pharmacy.

Increased Earnings and

Higher Vacancy Rates Reported

Total employment of pharmacists grew from 162,000 in 1988 to 185,000 in 1998, an

increase of 14 percent, just slightly less than the 19-percent employment growth rate

for the workforce overall. From 1988 to 1998, pharmacists’ earnings grew by 48

percent, compared with earnings growth of 36 percent for all workers. More

recently, from 1998 to 2000, pharmacists’ earnings increased much faster than those

of all workers. (See fig. 1.) Median weekly earnings for pharmacists grew from

$1,063 in 1998 to $1,243 in 2000, an increase of 17 percent, compared with a 10-

percent growth in earnings for all workers.
5 GAO-02-137R Supply of Selected Health Workers

Figure 1: Cumulative Percentage Increases in Earnings for Pharmacists and All

Workers, 1988-2000

Note: Growth for any specific 2-year period cannot be directly determined from the figure because

data represent cumulative earnings growth from 1988.

Source: GAO analysis of median weekly earnings for pharmacists and all workers as reported by BLS

using data from the Current Population Survey.

At the same time that salaries have increased, employers have reported greater

difficulty filling pharmacy positions. According to HRSA’s recent pharmacy

workforce study, several provider and professional associations have reported

increased vacancy rates and greater difficulty in hiring.7, 8 A recent American Hospital

Association (AHA) survey of hospitals reported an average pharmacist vacancy rate

of 21 percent in 2001, and half of all hospitals reported more difficulty in hiring

pharmacists than in the previous year.9

 An American Society of Health-System

 7

The Pharmacist Workforce: A Study of the Supply and Demand for Pharmacists (Washington, D.C.:

HRSA, Dec. 2000).

8

Caution should be used when comparing vacancy rates from different studies. Vacancy rates reported

by provider and professional organizations vary, and not all studies identify the methods used to

calculate these rates.

9

AHA and The Lewin Group, “The Hospital Workforce Shortage: Immediate and Future,” TrendWatch,

Vol. 3, No. 2 (June 2000).

0

10

20

30

40

50

60

70

80 Percentage change

1988 1990 1992 1994 1996 1998 2000

Year

Pharmacists

All workers
6 GAO-02-137R Supply of Selected Health Workers

Pharmacists survey of its pharmacy-director members reported that the average

pharmacist vacancy rate was 11 percent in 2000. In February 2001, the National

Association of Chain Drug Stores (NACDS) reported a 6-percent vacancy rate for

chain community pharmacies. The Department of Veterans Affairs (VA) recently

reported that many of its facilities have filled fewer than half of their authorized

pharmacist positions. According to HRSA, as a result of staffing shortages, some

federal facilities have cut back on pharmacy services, and in others, pharmacists are

being required to work longer hours.

Demand for Pharmacists May

Be Outpacing Growth in Supply

HRSA’s recent pharmacy workforce report suggested that several factors could be

contributing to a rising demand for pharmacy services. One factor is an increased

use of prescription medications, owing to the growth in the elderly population,

improved insurance coverage of prescription drugs, and the continuing development

of new medications. According to HRSA, from 1992 to 1999, the number of

prescriptions filled by community pharmacies grew by 44 percent to nearly 2.8

billion, and the percentage of retail prescriptions covered by insurance increased

from 44 to 78 percent. Another factor that may contribute to increased demand for

pharmacists is competition among retail pharmacies, resulting in new stores and

expanded hours of operation. Finally, although difficult to quantify, rising demand

may also result from the expansion of the pharmacist’s practice to include

participation in multidisciplinary patient care teams, increased responsibility for

ensuring patient safety, and patient education. According to HRSA, there is a lack of

reliable current data on the increased roles and responsibilities of pharmacists. The

last census survey of the pharmacy profession was conducted in 1991.

While the number of employed pharmacists continued to grow through 1998, both

pharmacy school applications and graduations have declined in recent years. The

number of pharmacy school applications fell by 29 percent from 1996 to 2000, and the

number of graduates fell by 9.3 percent from 1996 to 2000. While the reasons for

these declines are not clear, HRSA’s pharmacy workforce report indicated that the

decline in applications may be temporary and the number should begin to increase

again in response to rising salaries.

CONCERNS EMERGING ABOUT

LABORATORY AND RADIOLOGY

WORKFORCE SUPPLY

Employment and earnings data for laboratory and radiologic technologists and

technicians do not produce a clear picture about the current balance of supply and

demand for these workers. Although total employment for these workers grew from

1988 to 1998, the rate of growth fluctuated, and data to describe the most recent

trends are not available. During that decade, earnings for laboratory workers grew

about as fast as earnings for all workers, and earnings for radiology workers grew

faster. Despite reports of significant wage increases among certain segments of the
7 GAO-02-137R Supply of Selected Health Workers

laboratory workforce from 1998 to 2000, overall earnings growth among laboratory

and radiology workers lagged during this period compared with that of the overall

workforce. Some professional and industry groups have reported rising vacancy

rates for certain categories of laboratory and radiologic technologists and

technicians. There is also concern that the numbers of new entrants to these fields

may be declining.

Recent Trends in Employment

and Earnings Are Unclear

Data on recent trends in employment and earnings are not sufficient to draw

conclusions about the current balance of supply and demand for laboratory and

radiologic technologists and technicians. Overall employment for these workers

grew from 1988 to 1998, yet the rate of growth fluctuated, and reliable data are not

available to describe trends in employment beyond 1998. From 1988 to 1998, total

employment of laboratory technologists and technicians grew by 29.3 percent,

exceeding the 19.0-percent rate of overall employment growth. (See fig. 2.) The

strongest period of growth for laboratory workers during this period occurred from

1996 to 1998 (9.8 percent). Among radiologic technologists and technicians, total

employment grew by an estimated 22.7 percent from 1988 to 1998, just slightly more

than the rate of overall employment growth. From 1996 to 1998, however, total

employment among these workers declined by 6.9 percent.
8 GAO-02-137R Supply of Selected Health Workers

Figure 2: Cumulative Percentage Increases in Employment for Laboratory

Technologists and Technicians, Radiologic Technologists and Technicians, and All

Workers, 1988-98

Note: Growth for any specific 2-year period cannot be directly determined from the figure because

data represent cumulative employment growth from 1988.

Source: BLS, Office of Employment Projections.

From 1988 to 1998, median weekly earnings for laboratory technologists and

technicians combined grew by 35.7 percent, about as fast as earnings for all workers,

and earnings for radiology workers grew by 49.5 percent, faster than the rate of

growth for the overall workforce. Most recently, from 1998 to 2000, the rate of

earnings growth for laboratory and radiology workers lagged behind that of the

workforce overall. (See fig. 3.) While earnings for all workers grew by 10.1 percent

from 1998 to 2000, median weekly earnings for laboratory workers increased by 4.9

percent, from $566 to $594. Among radiology workers, median weekly earnings grew

by 5.9 percent, from $631 in 1998 to $668 in 2000. However, for certain segments of

the laboratory workforce, professional and industry groups are reported higher

increases in wages from 1998 to 2000.

0

5

10

15

20

25

30

35

1988 1990 1992 1994 1996 1998

Percentage growth

Laboratory technologist/technician

Radiology technologist/technician

All workers

Year
9 GAO-02-137R Supply of Selected Health Workers

Figure 3: Cumulative Percentage Increases in Earnings for Laboratory Technologists

and Technicians, Radiologic Technologists and Technicians, and All Workers, 1988-

2000

Note: Growth for any specific 2-year period cannot be directly determined from the figure because

data represent cumulative earnings growth from 1988.

Source: GAO analysis of median weekly earnings for laboratory and radiologic technologists and

technicians and all workers as reported by BLS using data from the Current Population Survey.

While the laboratory workforce overall has experienced only modest recent earnings

growth, the American Society of Clinical Pathologists (ASCP) reported significant

increases in wages for certain categories of laboratory technologists and

technicians.10 (See table 1.) From 1998 to 2000, wages increased faster for these

workers than during any 2-year period since this information was first collected in

1992. Wage increases ranged from 8.5 percent for medical laboratory technicians to

 10ASCP, 2000 Wage and Vacancy Survey of Medical Laboratories. This biennial survey of laboratory

managers who are listed with the ASCP’s Board of Registry documents average wage levels and

vacancy rates for several laboratory positions. Wage increases were calculated by comparing the

medians of the average wage levels reported for each position.

0

10

20

30

40

50

60

70

Laboratory technologist/technician

Radiology technologist/technician

All workers

Percentage change

1988 1990 1992 1994 1996 1998 2000

Year
10 GAO-02-137R Supply of Selected Health Workers

15.4 percent for histotechnologists. While little trend information has been collected

on radiologic technologists by professional organizations, available data suggest

there have been recent increases in wages for some of these workers. For example,

according to a recent industry survey, median salaries for radiographers, a radiologic

subspecialty, increased an average of 5.0 percent per year from 1997 to 2001, more

than the average increase of 3.4 percent per year from 1992 to 1997.11

Table 1: Percentage Increase in Wages for Selected Medical Laboratory Specialties,

1992-2000

Laboratory specialty 1992-94 1994-96 1996-98 1998-2000

Cytotechnologist 5.1 2.5 5.6 12.1

Histotechnologist 9.8 0.5 4.0 15.4

Medical technologist 5.4 4.3 3.9 11.9

Phlebotomist 3.9 6.3 5.9 10.0

Histologic technician 4.7 7.5 0.0 13.3

Medical laboratory technician 6.3 1.7 7.5 8.5

Note: Data exclude individuals at the supervisory or managerial level.

Source: ASCP, 2000 Wage and Vacancy Survey of Medical Laboratories.

Staffing Challenges

Reported for Some Workers

Difficulties in hiring and rising vacancy rates for laboratory and radiologic

technologists and technicians are being reported by some professional and industry

groups. According to a recent AHA survey, 43 percent of hospitals reported

experiencing more difficulty recruiting laboratory technologists compared with the

previous year, and 63 percent reported more difficulty recruiting radiologic

technologists. According to a 2000 American Healthcare Radiology Administrators’

(AHRA) survey, 42 percent of hospitals and 66 percent of nonhospital facilities

reported sufficient staffing for diagnostic radiography. This represents a decrease

since AHRA’s last survey in 1995, when 74 percent of both hospital and nonhospital

facilities reported sufficient staffing. AHA reported that vacancy rates for hospital

laboratory and radiologic technologists in 2001 were 12 percent and 18 percent,

respectively.12 According to representatives from both AHA and ASRT, rising vacancy

rates for laboratory and radiology workers appear to be a new phenomenon,

occurring only within the last 2 years.

According to the ASCP, vacancy rates for laboratory workers have fluctuated since it

conducted its first wage and vacancy survey in 1988, and no specialty has

experienced a persistent trend in one direction or the other. However, across all of

the surveys, the range of vacancy rates reported for the various specialties rose from

5.0 to 13.6 percent in 1988 to 10.0 to 22.2 percent in 2000. The most significant recent

 11American Society of Radiologic Technologists (ASRT), 2001 Wage and Salary Survey.

12“The Hospital Workforce Shortage: Immediate and Future,” 2001.
11 GAO-02-137R Supply of Selected Health Workers

increases in job vacancy rates were for cytotechnologists and histotechnologists,

with vacancy rates for these specialties doubling from 1998 to 2000. In addition, in

2000, laboratory managers reported higher turnover and increased difficulty in filling

all positions compared with the previous year.

Supply of New Laboratory

and Radiology Workers

Appears to Have Declined

Comprehensive data on new laboratory and radiology workers are not available.

However, data that are available from a range of organizations and educational

programs, while not representative of all new entrants to these occupations, suggest

that the numbers of new entrants to the laboratory and radiologic fields have

declined in recent years.13 While laboratory and radiologic technology education

programs appear to have sufficient capacity, the numbers of enrollees and graduates

declined from the 1995-96 school year to the 1999-2000 school year, the last year for

which data are available. These declines may affect the overall supply of workers in

coming years, and, while little is known about recent trends in the utilization of

radiology and laboratory services, demand is expected to rise as the U.S. population

ages.

The numbers of enrollees in both laboratory and radiologic technologist and

technician programs have declined in most occupational specialties in recent years,

although some specialties have experienced an increase. Declines in laboratory

enrollments from 1995 to 1999 ranged from about 16 percent for specialists in blood

banking technology to 33 percent for histotechnologists. Declines in radiologic

program enrollments ranged from about 15 percent for radiographers to about 38

percent for radiation therapists. In addition, the number of graduates of laboratory

and radiologic programs and the number of graduates taking certification exams have

declined. Although education programs for several laboratory and radiologic

specialties experienced increased graduations in the 1999-2000 school year, since

1995, the majority of education programs in these fields experienced declines in

graduates, from about 14 percent to about 38 percent. Since 1994, the number of

newly certified medical technologists declined by 33 percent, and the number of

radiographers taking certification exams for the first time also declined by 33

percent.

Representatives of industry and professional organizations believe the decrease in

enrollments is more the result of a loss of interest in these professions than a lack of

capacity in the current education system. Although the number of education

programs for laboratory and radiologic specialties has declined in recent years, the

decline in student enrollment cannot be attributed solely to a loss of capacity in the

education system. For example, officials from the Joint Review Committee on

 13These data generally do not include information on technologists who are employed in the field but

do not seek certification, nor do they include any data on technicians and professionals who receive

on-the-job training or training from sources other than formal education programs.
12 GAO-02-137R Supply of Selected Health Workers

Education in Radiologic Technology told us that most radiologic technology

programs are currently operating at only about 50 to 60 percent of their capacity.

One factor that may explain declining interest in these occupations is that other

business fields can offer higher salaries to technology-minded workers. For example,

representatives from professional and industry organizations cite competition from

the information technology and medical equipment manufacturing fields.

FUTURE SUPPLY AND DEMAND

FOR WORKERS DIFFICULT TO PREDICT

Demographic changes can be expected to exert pressure on both the demand for

pharmacy, laboratory, and radiology services and the supply of workers available to

provide them. However, the impact of current and future scientific and technologic

advances and management decisions about staff utilization are difficult to predict.

Improvements in some technologies may raise the productivity of the existing

workforce, but other advances in science may increase the volume and complexity of

health care services and create a need for workers with specialized or advanced

skills.

Demographic Changes Will Exert

Pressure on Supply and Demand

The future demand for health care services is expected to increase dramatically once

the baby boom generation reaches age 60 and beyond. The population aged 65 and

older will double from 2000 to 2030. Moreover, the population aged 85 and older is

the fastest growing age group in the United States. The growing number of elderly

persons will have a significant effect on the demand for health care in the future.

Older age groups tend to use a greater volume of health care services. For example,

in 1996, the average annual number of prescriptions for women aged 40 through 44

was about 9, compared with about 18 for those aged 60 through 64 and about 24 for

those aged 80 through 84.14

With the aging of the population comes the potential for a mismatch between the

future supply and demand for health care workers. From 2000 to 2030, the total

working-aged population—people aged 18 to 64—is expected to grow by only 16

percent. The ratio of the working-aged population to the population over age 85—

those likely to require the most services—will decline from 39.5 workers for each

person 85 and older in 2000 to 22.1 in 2030 and 14.8 in 2040. In addition, the current

workforce in the laboratory and radiology fields is aging, similar to the trends in the

nursing field. In 2000, over half of the certified laboratory technologist and

technician workforce was over age 45, similar to the registered nurse workforce, and

almost a third were over age 50. The median age for laboratory technologists and

technicians and radiologic technicians increased from about 34 in 1989 to about 38 in

1999.

 141996 Medical Expenditure Panel Survey (MEPS). Data on the number of prescriptions are for

persons with health insurance.
13 GAO-02-137R Supply of Selected Health Workers

Impact of Technology

and Staffing Patterns Unclear

Projecting future employment trends for these occupations requires an understanding

of the forces that will likely influence supply, demand, and utilization as well as

sufficient data to estimate their potential impact. Technological advances that

facilitate increased automation may enhance productivity by substituting for some

workers even as the demand for the particular service, test, or procedure continues

to rise. But other advances, such as new, more sophisticated tests and procedures,

may increase demand for workers with more advanced or specialized qualifications.

For radiology services, one analysis predicts that the demand for medical imaging

will increase by 140 percent over the next 20 years, while other studies suggest that

advances in the use of digital filming equipment and procedures may significantly

increase the productivity of the existing workforce. With regard to pharmaceutical

care, some health care systems—VA’s in particular—have made extensive use of

robotics and bar code reader systems to fill mail-order, outpatient, and inpatient

prescriptions. These systems have not only increased the productivity of VA

pharmacists by relieving them of many routine, time-consuming tasks but also

reduced medication errors in the inpatient setting.

Management decisions about how to use productivity-enhancing technology as well

as staff with differing skill mixes and qualifications may affect demand for workers.

For example, substitution of lower-skilled pharmacy technicians for some pharmacist

tasks may increase a pharmacist’s productivity. The number of pharmacy technicians

has risen in recent years: according to BLS, the number of employed pharmacy

technicians increased from approximately 83,000 in 1996 to 109,000 in 1998. VA, for

example, uses pharmacy technicians widely. Although VA still has a pharmacist

shortage, the expanded use of pharmacy technicians and new technologies has

limited the degree to which VA pharmacies have needed to restrict operations. While

the duties of laboratory technologists and technicians may overlap, there is little

evidence of systematic substitution of one type of worker for the other. However, the

simplification of some routine tests may enable people other than laboratory

personnel to complete tests that are now performed in laboratories.

- - - - -

As agreed with your office, unless you publicly announce its contents earlier, we plan

no further distribution of this letter until 30 days from its date. At that time, we will

send copies to interested parties. This letter will also be available on GAO’s home

page at http://www.gao.gov.
14 GAO-02-137R Supply of Selected Health Workers

If you or your staff have any questions, please call me on (202) 512-7119 or Helene

Toiv on (202) 512-7162. Other contributors were Eric Anderson, Beth Cameron

Feldpush, and Patricia Jones.

Sincerely yours,

Janet Heinrich

Director, Health Care—Public Health Issues

Enclosure
Enclosure Enclosure

15 GAO-02-137 Supply of Selected Health Workers

RELATED GAO PRODUCTS

Health Workforce: Ensuring Adequate Supply and Distribution Remains Challenging

(GAO-01-1042T, Aug. 1, 2001).

Nursing Workforce: Emerging Nurse Shortages Due to Multiple Factors (GAO-01-944,

July 10, 2001).

Nursing Workforce: Multiple Factors Create Nurse Recruitment and Retention

Problems (GAO-01-912T, June 27, 2001).

Nursing Workforce: Recruitment and Retention of Nurses and Nurse Aides Is a

Growing Concern (GA0-01-750T, May 17, 2001).

VA Patient Safety: Initiatives Promising But Continued Progress Requires Culture

Change (GAO/T-HEHS-00-167, July 27, 2000).

DOD and VA Health Care: Jointly Buying and Mailing Out Pharmaceuticals Could

Save Millions of Dollars (GAO/T-HEHS-00-121, May 25, 2000).

(290122)