Current Active Health Care Policy Decisions
Primary Care Years: New
Measures of Total Workforce Contribution
Head to Head: Physician
Assistants in 2000 Compared to Family Physicians in State and National Location
A number of health policy decisions are active at the
- Expanding graduate medical education positions such
that fewer are forced to take family medicine as a second or third choice
would be a disaster for the lower and middle income people in most need of
care, especially the Community Health Centers reporting great and growing
shortages. Further GME positions would move family medicine choice down from
7% or 8% to 5 or 6% from US MD Grads. Osteopathic sources and Caribbean
sources would not be able to add much acutely. International sources,
especially for rural practice are drying up as new Visa programs bypass the
J-1 visa obligation.
- Generic medical school expansions are not likely to
improve rural or underserved distribution or choice of family medicine.
Again only 1 in 100,000 per year is found in FP, just admit more non-FP
types.Family Medicine Standards and
- Specific expansions of generic rural born medical
students are likely to increase distribution of rural specialists, but will
not impact numbers of family physicians.
- Specific expansions of generic lower income origin
admissions are likely to improve underserved physician distributions, but
again not with a change in family medicine.
- Expansions involving younger, higher scoring students,
or elite medical schools is not likely to improve primary care, rural
careers, or underserved locations. Elite expansions will graduate more to
concentrate in major medical centers where the physicians with these
characteristics have 84% or more concentration already compared to 72% for
- Schools, states, and programs desiring more family
physicians will have to go deeper into the individual factors involved.
Selecting for rural origin or underserved origin and also selecting for
specific characteristics such as service orientation, people focus, or
obstacles overcome may well result in a concentration of family physicians.
Specific family medicine emphasis and training may also be important.
- Superselection - more
than just rural, or lower income
Legislative and Health
Medicine Central: National Comparisons of Workforce
Physician Workforce Studies