U.S. Healthcare and the Future Supply of Physicians - Hardcover

Hardcover

ISBN 10: 0765801981 ISBN 13: 9780765801982

Publisher: Routledge, 2003

Synopsis

Many different sectors of modern society influence the nation's healthcare system. Government, health insurance companies, managed care organizations, academic health centers, the pharmaceutical industry, and other groups all affect healthcare. In the areas of medical access, cost, and quality, the physician remains the key to the efficiency and effectiveness of healthcare services. Eli Ginzberg and Panos Minogiannis, in Ginzberg's final book, examine the supply of health personnel in the United States. They consider the ways it has been influenced by federal and state legislation, healthcare financing, the transformation of the hospital, managed care, and health trends in the last part of the twentieth century. Through this historical approach, the book identifies key moments in U.S. health policy history that have led to problems in the geographical distribution of medical personnel, gender and race representation in the health personnel pool, and subsequent attempts to resolve these problems. This volume pays special attention to current trends in healthcare and tries to forecast the direction of the debate over health personnel supply in the coming years. Chronic care conditions and the ageing of the population on the one hand and the penetration of managed care and the subsequent transformation of American hospitals on the other converge to present policymakers with tremendous challenges in financing healthcare. Ginzberg and Minogiannis argue that a more balanced production and distribution of U.S. health personnel will go far in easing the financial burden of healthcare and at the same time improve the quality of services provided to the American people.

About this title

About the Author

Eli Ginzberg (1909-2002) was A. Barton Hepburn Professor Emeritus of Economics and director of the program on Conservation of Human resources at Columbia University. He is the author of more than eighty books (many published by Transaction)—all with a human resource policy impact.

From The New England Journal of Medicine

As the debate over whether the United States has too few or too many physicians is rekindled, we are graced with the wisdom of Eli Ginzberg, the renowned health economist who died in December 2002. Ginzberg, an academic and activist economist at Columbia University, advised presidents from Franklin D. Roosevelt to Jimmy Carter and wrote prolifically about health policy and economics during his long career. Both intellectually and practically, he played an important role in the integration of women and members of minority groups into the American workforce, including into the field of medicine, and the desegregation of the military. In collaboration with his colleague Panos Minogiannis, Ginzberg wrote this slim, yet somewhat rambling, book describing the history of the physician workforce during the past century. For years we have heard that we were educating too many physicians. But last year, the Council on Graduate Medical Education, the agency charged with assessing physician-workforce issues and advising the Department of Health and Human Services, predicted that we will be facing a major shortage of physicians. Prominent pundits have published completely contradictory predictions. The arguments over whether we face a crisis of oversupply or undersupply of physicians can seem so arcane, complicated, and easily manipulated that some believe the debate deserves to be dismissed entirely. Ginzberg and Minogiannis provide a historical perspective on the current controversies, revealing the complex issues underlying them. Indeed, the authors point out that U.S. policymakers have often focused on the topic of the supply of physicians in addressing larger issues in health care. Questions of how to ensure equitable access to care, improve the quality of health care, contain costs, and best deliver services have shaped the assessments of how many physicians we should have and the attempts to regulate those numbers. The authors describe the effects that factors such as the financing of health care and graduate medical education, changes in health care delivery, and the passage of the 1964 Civil Rights Act have had on the numbers and kinds of doctors in the United States. They point out that other social and health care reforms have often had more of an effect on the medical profession than have policies directed specifically at manipulating the supply and distribution of doctors. For example, since passage of the Civil Rights Act, the number of black graduates from U.S. medical schools has increased by a factor of four. (Specific efforts to increase the number of minority medical graduates, such as the "3000 by 2000" campaign of the Association of American Medical Colleges, have not met with such success.) In addition, women, whose numbers among U.S. physicians were the lowest of any industrialized country in the early 1960s, made up more than 40 percent of medical school graduates in 1999. Ginzberg and Minogiannis might have taken a more analytic approach that could have helped to resolve the current debate regarding the size, demographic characteristics, and division by specialty of the physician workforce. But within the context of a historical perspective, they admonish us not to believe that we can profoundly reform health care merely by changing the supply of physicians. Instead, they ask us to grapple with the complexities that underlie the controversies. Margaret Bowen Wheeler, M.D.
Copyright © 2004 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.

About this edition

• Publisher: Routledge
• Publication date: 2003
• ISBN 10: 0765801981
• ISBN 13: 9780765801982
• Binding: Hardcover
• Language: English
• Edition number: 1
• Number of pages: 128
• Editor: Minogiannis Panos