Evidence for Expanding Physician Supply

William A. Curry; Clyde Barganier

doi:10.7326/0003-4819-142-6-200503150-00020

Letters |15 March 2005

Evidence for Expanding Physician Supply

William A. Curry, MD; Clyde Barganier, DrPH

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TO THE EDITOR:

Dr. Cooper (1) notes that projections of physician workforce needs suffer from a lack of information about physician work effort, particularly from women and older physicians. This is a critical observation. While Dr. Cooper's model for projecting future needs is impressive, its usefulness—and that of any model—will be severely limited if the baseline data are faulty. The lack of full-time-equivalent data may be a major reason that so many projections of workforce needs have been contradictory (2-4). As Dr. Cooper noted, recent reports suggest either a shortage of primary care physicians or a surplus (5, 6).

The inadequacy goes even deeper than the lack of work effort data: Current systems used to identify and classify physician practice specialties are seriously flawed. This includes data used to designate physician shortage areas by state and federal governmental agencies. Most of these databases are derived from licensure or professional society information. The specialty, practice site, and effort data from these systems appear likely to overstate the number of primary care physicians and to understate the number of subspecialists. A recent pilot study in rural Alabama demonstrated this by comparing onsite surveys to existing databases (Coleman W. Unpublished data. 2004).

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2005 American College of Physicians

Letters |15 March 2005

Evidence for Expanding Physician Supply

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Letters |15 March 2005

Evidence for Expanding Physician Supply

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