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The U.S. Physician Workforce: Beyond the Numbers Fitzhugh Mullan, MD The George Washington University National Health Policy Conference February 13, 2007.

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Presentation on theme: "The U.S. Physician Workforce: Beyond the Numbers Fitzhugh Mullan, MD The George Washington University National Health Policy Conference February 13, 2007."— Presentation transcript:

1 The U.S. Physician Workforce: Beyond the Numbers Fitzhugh Mullan, MD The George Washington University National Health Policy Conference February 13, 2007

2 Physician Workforce History: Key Dates 1963 – Enactment of the Health Professions Education Assistance Act –Construction, Scholarships, Capitation $$$ 1964 – Civil Rights Act 1971 – Reauthorization of the HPEA –NPs and PAs –AHECs 1976 – Reauthorization of the HPEA –Funding significantly decreased –PC and underservice added as priorities

3 Key Dates II 1980 – GMENAC Report –Predicted substantial MD surpluses 1983 – Medicare PPS Implemented –DME and IGME payments begun 1992-1994 – Health Care Reform Debate –GME funding linked to workforce goals proposed...unsuccessfully 1994 – COGME Calls for 50-50/110

4 Key Dates III 1997 – Balanced Budget Amendment –Caps Medicare funded residency slots 2005 – COGME Calls for 15% Increase in Medical Student Enrollment 2006 – AAMC Calls for 30% Increase in Medical Student Enrollment 2007 – Title VII Slated for Elimination

5 What Happened Medical Schools Increased from 87 in 1965 to 126 in 1980 Graduates Increased from ~8,000/yr in 1965 to ~16,500/yr in 1980 From 1980 to the present graduates have remained at ~16,500/yr Osteopathic Schools have grown steadily from 5 to 20 now graduating ~3000/yr

6 What Happened II Residents grew from ~60,000 in 1965 to ~100,000 in 1992 and have remained at that level IMGs have grown from ~10% of residents to ~25% of residents…and 25% of practicing physicians today

7 Applicants to Allopathic Medical Schools and Enrollment (Source: AMA) YearNo. of Applicants No. AcceptedApplied: Accepted Ratio No. EnrolledMean GPA of Applicants 198036,10017,1462.116,5903.32 199237,40817,4642.116,2893.24 199342,80817,3622.516,3073.26 199445,36417,3172.616,2873.28 199546,59117,3572.716,2533.31 199646,96717,3852.716,2013.34 199743,01817,3132.516,1653.38 199840,99817,3742.416,1703.40 199938,44917,4242.216,2213.43 200037,09217,5382.116,3013.44 200134,85917,4562.016,3653.45 200233,62517,5921.916,4883.46 200334,78617,5392.016,5383.47 200435,73517,6622.016,6483.47 200537,37317,9872.117,0033.48 200639,10818,4422.117,3703.48

8 Number of Residents in U.S. Allopathic Training Programs from 1993-2003 (Source: AMA)

9 Number of Residents in U.S. Allopathic Training Programs According to the Type of Medical School Attended from 1993-2003 (Source: AMA)

10 Supply of Active Physicians (MD & DO) and Ratio to Population Actual 1950-1990 and Projected 2000-2020 Physicians Per 100,000 Population Population is U.S. civilian population including possessions

11 Title VII Appropriations 1964- 2007

12 Title VII and Medicare GME (2006 dollars)

13 Characteristics of Physician Workforces of US, UK, Canada, and Australia. CountryPhysicians per 100,000 population % IMGs in MD workforce (total IMGs) % IMGs from lower income countries % IMGs from other three countries US29325.0 (208,733)60.26.5 UK23128.3 (39,266)75.22.5 Canada22023.1 (15,701)43.422.3 Australia27126.5 (14,346)40.033.5

14 G. Anderson et al. Health AffairsHealth Affairs, 25, no. 3 (2006)

15 Current Questions More Medical Schools? More Residents? More Medicare GME? More/less physicians from abroad? Would more doctors make America healthier…happier…richer…poorer?


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