The Physician Work Force: Does the Marketplace Set National Policy?
Authors: Robert H. Fletcher
Journal: Annals of Internal Medicine (1994)

Editorials1 November 1994The Physician Work Force: Does the Marketplace Set National Policy?Robert H. Fletcher, MD, MSc and Gordon T. Moore, MD, MPHRobert H. Fletcher, MD, MScHarvard Medical School and Harvard Community Health Plan; Boston, MA 02215Search for more papers by this author and Gordon T. Moore, MD, MPHHarvard Medical School and Harvard Community Health Plan; Boston, MA 02215Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-121-9-199411010-00013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Policymakers now believe that a larger role for generalists would help cure this country's health care ills, especially high costs, insufficient preventive care, and limited access to care. This belief stems from several sources [1]: the proportion of generalists in successful managed care plans in this country [2] and in other countries, where the health and satisfaction of the people are higher, and the costs are lower, than in the United States [3]; evidence that the cost of care for similar patients is higher when those patients are treated by specialists rather than generalists [4]; and dispassionate examination of the ...References1. Wartmen SA, Wilson M, Kahn N. The generalist health care workforce: issues and goals. J Gen Intern Med. 1994; 9(Suppl 1):S7-13. Google Scholar2. Weiner JP. Forecasting the effects of health reform on U.S. physician workforce requirement. JAMA. 1994; 272:222-30. Google Scholar3. World Development Report 1993. Investing in Health. World Development Indicators. New York: Oxford University Press; 1993. Google Scholar4. Greenfield S, Nelson EC, Zubkoff M, Manning W, Rogers W, Kravitz RL, et al. Variations in resource utilization among medical specialties and systems of care. Results from the medical outcomes study. JAMA. 1992; 267:1624-30. Google Scholar5. Council on Graduate Medical Education. Improving Access to Health Care through Physician Workforce Reform: Directions for the 21st Century. Rockville, Maryland: U.S. Department of Health and Human Services, Public Health Service, Health Resources and Services Administration; 1992. Google Scholar6. General internal medicine and general internists: recognizing a national need. Federated Council for Internal Medicine. Ann Intern Med. 1992; 117:778-9. Google Scholar7. Redressing the specialist/generalist imbalance through education and training. J Gen Intern Med. 1994; 9(Suppl):S1-130. Google Scholar8. Christakis NA, Jacobs JA, Messikomer CM. Change in self-definition from specialist to generalist in a national sample of physicians. Ann Intern Med. 1994; 121:669-75. Google Scholar9. Kindig DA, Cultice JM, Mullan F. The elusive generalist physician. Can we reach a 50% goal? JAMA. 1993; 270:1069-73. Google Scholar10. Moore GT. Will the power of the marketplace produce the workforce we need? Inquiry. 1994; (In press). Google Scholar11. Schroeder SA. The latest forecast. Managed care collides with physician supply. JAMA. 1994; 272:239-40. Google Scholar12. Earp JA, Fletcher SW, O'Malley MS, Fletcher RH. Attitudes of internal medicine subspecialty fellows toward primary care. Arch Intern Med. 1994; 44:329-33. Google Scholar Author, Article, and Disclosure InformationAuthors: Robert H. Fletcher, MD, MSc; Gordon T. Moore, MD, MPHAffiliations: Harvard Medical School and Harvard Community Health Plan; Boston, MA 02215 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoChange in Self-Definition from Specialist to Generalist in a National Sample of Physicians Nicholas A. Christakis , Jerry A. Jacobs , and Carla M. Messikomer Metrics 1 November 1994Volume 121, Issue 9Page: 712-713KeywordsGraduate medical educationHealth careMedical educationMotivationPatientsQuality of lifeResearch grantsResidencySub-specialty careTaste ePublished: 15 August 2000 Issue Published: 1 November 1994 Copyright & PermissionsCopyright © 1994 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...