The Complexity of the Physician
Workforce Equation
The Complexity of the
Workforce Equation
Academy Health/Health Affairs
National Health Policy Conference
Darrell G. Kirch, M.D.
President and CEO, AAMC
February 3, 2009
Source: JAMA, June 11, 2008; 299: 2680 - 2682.
Physician Workforce
Workforce in its Larger Context
American Psyche
Demand Side Variables
• Coverage reform
U.S. MD and DO
• Financing reform
enrollment
• Health services utilization
Physician retirement
Gender and generational
and variation
differences
• Population growth rate
Physician production time
• Aging and utilization
Physician debt
• Emerging treatments
IMG influx
• Physician distribution
Number of GME positions
• IMGs in HPSAs
• U.S. economy
• U.S. NP and PA enrollment
Supply Side Variables
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What Stands in Our Way?
Care
Model
Workforce
Interests
Economic
Model
Institutional Culture
Reasons to Be Encouraged
• Discussions like today’s show that workforce is
• Inadequate data (timeliness)
on the “front burner”
• These discussions are being linked to broader
• No common point of analytic integration
health system changes
• Programs with promise are being reinvigorated
• The limits of market forces when it comes to
(e.g., NHSC)
health care
• There is increased focus on the delivery model
and on the impact of incentives (e.g., medical
home, payments to primary care physicians)
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