THE APPROPRIATE CONFIGURATION OF THE UNITED STATES PHYSICIAN SUPPLY (SURPLUS, GMENAC REPORT, MEDICAL EDUCATION, MANPOWER PLANNING)

We are adding 16,000 new physicians to our national supply annually. By 1990, assuming that the physician supply continues to increase at the current rate, we could have one physician for every 400 persons in the United States.;The Graduate Medical Education National Advisory Committee (GMENAC) was appointed in 1976 to advise the nation on policies to assure that the number of physicians in each specialty would be in balance with our requirements. The committee found that we would have too many physicians by 1990; that we would continue to have imbalances in most of the specialties and unevenness in geographic distribution. Their major policy recommendation was to reduce the size of the entering medical school classes, ignoring the need for modifying the graduate training programs. We have not significantly reduced the supply, and there has been little interest in reducing or regulating the numbers of students at the graduate or undergraduate level as yet.;This dissertation examines the issue of physician supply from an historical and multidisciplinary perspective. The number of physicians fell rapidly to a low point in 1940, and then expanded steadily. Planning for the future supply of physicians was undertaken regularly by federal and private organizations. There was a characteristic way of defining the problems of need in each period. The problems in subsequent periods were generated by achieving the goals established in previous eras.;Knowledge has grown primarily by understanding the mistakes of the past. In this light, the way in which the GMENAC went about estimating the future requirements is questioned as the only model for the future. Recommendations are made about how to move in a preferable direction in planning for the appropriate number of physicians.