Scarce physicians encounter scarce foundations: A call for action

Health Affairs

Volumn 23, Issue 6, 2004, Pages 243-249

  Cooper, Richard A ^a  

^a MEDICAL COLLEGE OF WISCONSIN   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

CURRICULUM; HEALTH CARE; HEALTH SERVICE; HUMAN; MEDICAL EDUCATION; MEDICAL SCHOOL; PHYSICIAN; REVIEW; UNITED STATES;

CONSUMER ADVOCACY; FOUNDATIONS; FUND RAISING; MEDICALLY UNDERSERVED AREA; UNITED STATES;

EID: 8844283426     PISSN: 02782715     EISSN: None     Source Type: Journal    
DOI: 10.1377/hlthaff.23.6.243     Document Type: Review

References (58)

1. J. Bryce, The American Commonwealth, 3d ed., vol. 2 (New York: Macmillan Press, 1903), 723.
2. R.H. Bremner, American Philanthropy (Chicago: University of Chicago Press, 1960); and L.J. Friedman and M.D. McGarvie, eds., Charity, Philanthropy, and Civility in American History (Cambridge: Cambridge University Press, 2003).
3. R.H. Bremner, American Philanthropy (Chicago: University of Chicago Press, 1960); and L.J. Friedman and M.D. McGarvie, eds., Charity, Philanthropy, and Civility in American History (Cambridge: Cambridge University Press, 2003).
4. A. Flexner, Medical Education in the United States and Canada (Boston: Carnegie Foundation for the Advancement of Teaching - The Merrymount Press, 1910).
5. T.N. Bonner, Iconoclast: Abraham Flexner and a Life in Learning (Baltimore: Johns Hopkins University Press, 2002).
6. Ibid.; and K.M. Ludmerer, Learning to Heal: The Development of American Medical Education (Baltimore: Johns Hopkins University Press, 1985).
7. Ibid.; and K.M. Ludmerer, Learning to Heal: The Development of American Medical Education (Baltimore: Johns Hopkins University Press, 1985).
8. A. Flexner, Medical Education: A Comparative Study (New York: Macmillan Company, 1925).
9. J.R. Schofield, New and Expanded Medical Schools, Mid-Century to the 1980s (San Francisco: Jossey-Bass, 1984).
10. Ibid., 35-40, 63.
11. R.A. Cooper et al., "Economic and Demographic Trends Signal an Impending Physician Shortage," Health Affairs 21, no. 1 (2002): 140-154; R.A. Cooper, "There's a Shortage of Specialists: Is Anyone Listening?" Academic Medicine 77, no. 8 (2002): 761-766; R.A. Cooper, S.J. Stoflet, and S.A. Wartman, "Perceptions of Physician Supply: The Views of Medical School Deans and State Medical Societies," Journal of the American Medical Association 290, no. 22 (2003): 2292-2295; Council on Graduate Medical Education, Reassessing Physician Workforce Policy Guidelines for the U.S., 2000-2020 (Washington: U.S. Department of Health and Human Services, 2003); and D. Blumenthal, "New Steam from an Old Cauldron - The Physician Supply Debate," New England Journal of Medicine 350, no. 17 (2004): 1780-1787.
12. R.A. Cooper et al., "Economic and Demographic Trends Signal an Impending Physician Shortage," Health Affairs 21, no. 1 (2002): 140-154; R.A. Cooper, "There's a Shortage of Specialists: Is Anyone Listening?" Academic Medicine 77, no. 8 (2002): 761-766; R.A. Cooper, S.J. Stoflet, and S.A. Wartman, "Perceptions of Physician Supply: The Views of Medical School Deans and State Medical Societies," Journal of the American Medical Association 290, no. 22 (2003): 2292-2295; Council on Graduate Medical Education, Reassessing Physician Workforce Policy Guidelines for the U.S., 2000-2020 (Washington: U.S. Department of Health and Human Services, 2003); and D. Blumenthal, "New Steam from an Old Cauldron - The Physician Supply Debate," New England Journal of Medicine 350, no. 17 (2004): 1780-1787.
13. R.A. Cooper et al., "Economic and Demographic Trends Signal an Impending Physician Shortage," Health Affairs 21, no. 1 (2002): 140-154; R.A. Cooper, "There's a Shortage of Specialists: Is Anyone Listening?" Academic Medicine 77, no. 8 (2002): 761-766; R.A. Cooper, S.J. Stoflet, and S.A. Wartman, "Perceptions of Physician Supply: The Views of Medical School Deans and State Medical Societies," Journal of the American Medical Association 290, no. 22 (2003): 2292-2295; Council on Graduate Medical Education, Reassessing Physician Workforce Policy Guidelines for the U.S., 2000-2020 (Washington: U.S. Department of Health and Human Services, 2003); and D. Blumenthal, "New Steam from an Old Cauldron - The Physician Supply Debate," New England Journal of Medicine 350, no. 17 (2004): 1780-1787.
14. R.A. Cooper et al., "Economic and Demographic Trends Signal an Impending Physician Shortage," Health Affairs 21, no. 1 (2002): 140-154; R.A. Cooper, "There's a Shortage of Specialists: Is Anyone Listening?" Academic Medicine 77, no. 8 (2002): 761-766; R.A. Cooper, S.J. Stoflet, and S.A. Wartman, "Perceptions of Physician Supply: The Views of Medical School Deans and State Medical Societies," Journal of the American Medical Association 290, no. 22 (2003): 2292-2295; Council on Graduate Medical Education, Reassessing Physician Workforce Policy Guidelines for the U.S., 2000-2020 (Washington: U.S. Department of Health and Human Services, 2003); and D. Blumenthal, "New Steam from an Old Cauldron - The Physician Supply Debate," New England Journal of Medicine 350, no. 17 (2004): 1780-1787.
15. R.A. Cooper et al., "Economic and Demographic Trends Signal an Impending Physician Shortage," Health Affairs 21, no. 1 (2002): 140-154; R.A. Cooper, "There's a Shortage of Specialists: Is Anyone Listening?" Academic Medicine 77, no. 8 (2002): 761-766; R.A. Cooper, S.J. Stoflet, and S.A. Wartman, "Perceptions of Physician Supply: The Views of Medical School Deans and State Medical Societies," Journal of the American Medical Association 290, no. 22 (2003): 2292-2295; Council on Graduate Medical Education, Reassessing Physician Workforce Policy Guidelines for the U.S., 2000-2020 (Washington: U.S. Department of Health and Human Services, 2003); and D. Blumenthal, "New Steam from an Old Cauldron - The Physician Supply Debate," New England Journal of Medicine 350, no. 17 (2004): 1780-1787.
16. See Cooper et al., "Economic and Demographic Trends"; Blumenthal, "New Steam"; and S. Folland, A.C. Goodman, and M. Stano, The Economics of Health and Health Care (Upper Saddle River, N.J.: Prentice-Hall, 2001), 204-216.
17. See Cooper et al., "Economic and Demographic Trends"; Blumenthal, "New Steam"; and S. Folland, A.C. Goodman, and M. Stano, The Economics of Health and Health Care (Upper Saddle River, N.J.: Prentice-Hall, 2001), 204-216.
18. See Cooper et al., "Economic and Demographic Trends"; Blumenthal, "New Steam"; and S. Folland, A.C. Goodman, and M. Stano, The Economics of Health and Health Care (Upper Saddle River, N.J.: Prentice-Hall, 2001), 204-216.
19. Josiah Macy Jr. Foundation, Report of the Josiah Macy Jr. Foundation for July 1, 1991 through June 30, 1992 (New York: Josiah Macy Jr. Foundation, 1992); Pew Health Professions Commission, Critical Challenges: Revitalizing the Health Professions for the Twenty-first Century (San Francisco: Pew Health Professions Commission, 1995); and S.A. Schroeder and L.G. Sandy, "Specialty Distribution of U.S. Physicians - The Invisible Drivers of Health Care Spending," New England Journal of Medicine 328, no. 13 (1993): 961-963.
20. Josiah Macy Jr. Foundation, Report of the Josiah Macy Jr. Foundation for July 1, 1991 through June 30, 1992 (New York: Josiah Macy Jr. Foundation, 1992); Pew Health Professions Commission, Critical Challenges: Revitalizing the Health Professions for the Twenty-first Century (San Francisco: Pew Health Professions Commission, 1995); and S.A. Schroeder and L.G. Sandy, "Specialty Distribution of U.S. Physicians - The Invisible Drivers of Health Care Spending," New England Journal of Medicine 328, no. 13 (1993): 961-963.
21. Josiah Macy Jr. Foundation, Report of the Josiah Macy Jr. Foundation for July 1, 1991 through June 30, 1992 (New York: Josiah Macy Jr. Foundation, 1992); Pew Health Professions Commission, Critical Challenges: Revitalizing the Health Professions for the Twenty-first Century (San Francisco: Pew Health Professions Commission, 1995); and S.A. Schroeder and L.G. Sandy, "Specialty Distribution of U.S. Physicians - The Invisible Drivers of Health Care Spending," New England Journal of Medicine 328, no. 13 (1993): 961-963.
22. American Medical Association, "AMA Revises Policy to Address Continued Demand for Physicians," Press Release, 9 December 2003, www.ama-assn.org/ama/pub/article/print/1616-8229.html (27 August 2004); Association of American Medical Colleges, "The Physician Workforce: Position Statement - June 2002" (Washington: AAMC, 2002); and Jordan J. Cohen, president, AAMC, letter to Mark B. McClellan, administrator, Centers for Medicare and Medicaid Services, regarding rule change CMS-1428-P, 12 July 2004.
23. American Medical Association, "AMA Revises Policy to Address Continued Demand for Physicians," Press Release, 9 December 2003, www.ama-assn.org/ama/pub/article/print/1616-8229.html (27 August 2004); Association of American Medical Colleges, "The Physician Workforce: Position Statement - June 2002" (Washington: AAMC, 2002); and Jordan J. Cohen, president, AAMC, letter to Mark B. McClellan, administrator, Centers for Medicare and Medicaid Services, regarding rule change CMS-1428-P, 12 July 2004.
24. American Medical Association, "AMA Revises Policy to Address Continued Demand for Physicians," Press Release, 9 December 2003, www.ama-assn.org/ama/pub/article/print/1616-8229.html (27 August 2004); Association of American Medical Colleges, "The Physician Workforce: Position Statement - June 2002" (Washington: AAMC, 2002); and Jordan J. Cohen, president, AAMC, letter to Mark B. McClellan, administrator, Centers for Medicare and Medicaid Services, regarding rule change CMS-1428-P, 12 July 2004.
25. COGME, Reassessing Physician Workforce Policy.
26. Cooper et al., "Economic and Demographic Trends."
27. COGME, Reassessing Physician Workforce Policy.
28. D.E. Hecker, "Occupational Employment Projections to 2012," Monthly Labor Review 127, no. 2 (2004): 80-105; S. Heffler et al., "Health Spending Projections for 2002-2012," Health Affairs, 7 February 2003, content.healthaffairs.org/cgi/content/abstract/hlthaff.w3.54 (27 August 2004); D. Holtz-Eakin, director, Congressional Budget Office, "Medicare's Long-Term Financial Condition," testimony before the Joint Economic Committee, U.S. Congress, 10 April 2003, www.cbo.gov/showdoc.cfm?index= 4161&sequence=0 (26 August 2004); and National Center for Health Workforce Analysis, Projected Supply, Demand, and Shortages of Registered Nurses: 2000-2020 (Washington: DHHS, 2002).
29. D.E. Hecker, "Occupational Employment Projections to 2012," Monthly Labor Review 127, no. 2 (2004): 80-105; S. Heffler et al., "Health Spending Projections for 2002-2012," Health Affairs, 7 February 2003, content.healthaffairs.org/cgi/content/abstract/hlthaff.w3.54 (27 August 2004); D. Holtz-Eakin, director, Congressional Budget Office, "Medicare's Long-Term Financial Condition," testimony before the Joint Economic Committee, U.S. Congress, 10 April 2003, www.cbo.gov/showdoc.cfm?index= 4161&sequence=0 (26 August 2004); and National Center for Health Workforce Analysis, Projected Supply, Demand, and Shortages of Registered Nurses: 2000-2020 (Washington: DHHS, 2002).
30. D.E. Hecker, "Occupational Employment Projections to 2012," Monthly Labor Review 127, no. 2 (2004): 80-105; S. Heffler et al., "Health Spending Projections for 2002-2012," Health Affairs, 7 February 2003, content.healthaffairs.org/cgi/content/abstract/hlthaff.w3.54 (27 August 2004); D. Holtz-Eakin, director, Congressional Budget Office, "Medicare's Long-Term Financial Condition," testimony before the Joint Economic Committee, U.S. Congress, 10 April 2003, www.cbo.gov/showdoc.cfm?index= 4161&sequence=0 (26 August 2004); and National Center for Health Workforce Analysis, Projected Supply, Demand, and Shortages of Registered Nurses: 2000-2020 (Washington: DHHS, 2002).
31. D.E. Hecker, "Occupational Employment Projections to 2012," Monthly Labor Review 127, no. 2 (2004): 80-105; S. Heffler et al., "Health Spending Projections for 2002-2012," Health Affairs, 7 February 2003, content.healthaffairs.org/cgi/content/abstract/hlthaff.w3.54 (27 August 2004); D. Holtz-Eakin, director, Congressional Budget Office, "Medicare's Long-Term Financial Condition," testimony before the Joint Economic Committee, U.S. Congress, 10 April 2003, www.cbo.gov/showdoc.cfm?index= 4161&sequence=0 (26 August 2004); and National Center for Health Workforce Analysis, Projected Supply, Demand, and Shortages of Registered Nurses: 2000-2020 (Washington: DHHS, 2002).
32. R.A. Cooper, "Medical Schools and Their Applicants: An Analysis," Health Affairs 22, no. 4 (2003): 71-84.
33. Cooper et al., "Perceptions of Physician Supply."
34. W.T. Mallon et al., Mini-Med: The Role of Regional Campuses in U.S. Medical Education (Washington: AAMC, 2003).
35. AAMC, AAMC Data Book (Washington: AAMC, 2003).
36. A.M. Singer, 2002 Annual Report on Osteopathic Medical Education (Washington: American Association of Colleges of Osteopathic Medicine, 2003).
37. R.A. Garibaldi et al., "The In-Training Examination in Internal Medicine: An Analysis of Resident Performance over Time," Annals of Internal Medicine 137, no. 6 (2002): 505-510; and "Medical Schools: Four That Flunk" Hartford Courant, 29 June 2003.
38. R.A. Garibaldi et al., "The In-Training Examination in Internal Medicine: An Analysis of Resident Performance over Time," Annals of Internal Medicine 137, no. 6 (2002): 505-510; and "Medical Schools: Four That Flunk" Hartford Courant, 29 June 2003.
39. The percentages cited were derived from N.L. Eckhert, "The Global Pipeline: Too Narrow, Too Wide, or Just Right?" Medical Education 36, no. 7 (2002): 606-613; and data from the Educational Commission for Foreign Medical Graduates. See P. Bundred and T. Gibbs, "Facing Up to the Realities of Global Medical Education in the Twenty-first Century," Medical Education 36, no. 7 (2002): 600-601, concerning depleting health care systems.
40. The percentages cited were derived from N.L. Eckhert, "The Global Pipeline: Too Narrow, Too Wide, or Just Right?" Medical Education 36, no. 7 (2002): 606-613; and data from the Educational Commission for Foreign Medical Graduates. See P. Bundred and T. Gibbs, "Facing Up to the Realities of Global Medical Education in the Twenty-first Century," Medical Education 36, no. 7 (2002): 600-601, concerning depleting health care systems.
41. R. Young et al., The International Market for Medical Doctors: Perspectives on the Positioning of the U.K. (Manchester, England: National Primary Care Research and Development Centre, 2003).
42. Cohen, letter to McClellan.
43. COGME, Reassessing Physician Workforce Policy; and Cooper et al., "Economic and Demographic Trends."
44. COGME, Reassessing Physician Workforce Policy; and Cooper et al., "Economic and Demographic Trends."
45. J.P. Newhouse and G.R. Wilensky, "Paying for Graduate Medical Education: The Debate Goes On," Health Affairs 20, no. 2 (2001): 136-147; and R.A. Cooper and L. H. Aiken, "Human Inputs: The Health Care Workforce and Medical Markets," Journal of Health Politics, Policy and Law 26, no. 5 (2001): 925-938.
46. J.P. Newhouse and G.R. Wilensky, "Paying for Graduate Medical Education: The Debate Goes On," Health Affairs 20, no. 2 (2001): 136-147; and R.A. Cooper and L. H. Aiken, "Human Inputs: The Health Care Workforce and Medical Markets," Journal of Health Politics, Policy and Law 26, no. 5 (2001): 925-938.
47. Cooper, "Medical Schools and Their Applicants."
48. AAMC, "The Predictive Validity of the Medical College Admission Test," Contemporary Issues in Medical Education 3, no. 2 (2000): 1-2; E. Ferguson, D. James, and L. Madeley, "Factors Associated with Success in Medical School: Systematic Review of the Literature," British Medical Journal 324, no. 7343 (2002): 952-957; and P. Hughes, "Can We Improve How We Select Medical Students?" Journal of the Royal Society of Medicine 95, no. 1 (2002): 18-22.
49. AAMC, "The Predictive Validity of the Medical College Admission Test," Contemporary Issues in Medical Education 3, no. 2 (2000): 1-2; E. Ferguson, D. James, and L. Madeley, "Factors Associated with Success in Medical School: Systematic Review of the Literature," British Medical Journal 324, no. 7343 (2002): 952-957; and P. Hughes, "Can We Improve How We Select Medical Students?" Journal of the Royal Society of Medicine 95, no. 1 (2002): 18-22.
50. AAMC, "The Predictive Validity of the Medical College Admission Test," Contemporary Issues in Medical Education 3, no. 2 (2000): 1-2; E. Ferguson, D. James, and L. Madeley, "Factors Associated with Success in Medical School: Systematic Review of the Literature," British Medical Journal 324, no. 7343 (2002): 952-957; and P. Hughes, "Can We Improve How We Select Medical Students?" Journal of the Royal Society of Medicine 95, no. 1 (2002): 18-22.
51. Flexner, Medical Education.
52. P.A. Cuff and N. Vanselow, eds., Improving Medical Education: Enhancing the Behavioral and Social Science Content of Medical School Curricula (Washington: National Academies Press, 2004).
53. R.A. Cooper and S.J. Stoflet, "Diversity and Consistency: The Challenge of Maintaining Quality in a Multidisciplinary Workforce," Journal of Health Services Research and Policy 9, no. 1 Supp. (2004): 39-47
54. Ibid.; and R.A. Cooper, P. Laud, and C.L. Dietrich, "Current and Projected Workforce of Nonphysician Clinicians," Journal of the American Medical Association 280, no. 9 (1998): 788-794.
55. Ibid.; and R.A. Cooper, P. Laud, and C.L. Dietrich, "Current and Projected Workforce of Nonphysician Clinicians," Journal of the American Medical Association 280, no. 9 (1998): 788-794.
56. W.M. Sage, "The Forgotten Third: Liability Insurance and the Medical Malpractice Crisis," Health Affairs 23, no. 4 (2004): 10-21.
57. L.H. Einhorn et al., "American Society of Clinical Oncology 2001 Presidential Initiative: Impact of Regulatory Burdens on Quality Cancer Care," Journal of Clinical Oncology 20, no. 24 (2002): 4722-4726.
58. Schofield, New and Expanded Medical Schools, 36.