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. 1995 Sep;222(3):215–228. doi: 10.1097/00000658-199509000-00001

The health work force, generalism, and the social contract.

G F Sheldon 1
PMCID: PMC1234796  PMID: 7677453

Abstract

Since 1990, society has been evolving through a period of significant transformation. In response to an increasingly information-rich and knowledge-based environment, the work force for most of society is becoming more specialized. Medicine is one of the few areas developing a work force which emphasizes generalism. For our current needs, the transitional work force has overproduced physicians. Because the overproduction has been uneven by specialty, it is deceptive to evaluate growth collectively rather than by individual subspecialty. Future shifts in age and types of illness combined with enhanced technology will transform the public's expectations of the American health care system. The type and number of physicians that will be needed in the future will be substantially different than in the past, so current patterns in physician education may not address the population's future demands.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bondurant S. Health care reform continues: themes for academic medicine. Acad Med. 1995 Feb;70(2):93–97. doi: 10.1097/00001888-199502000-00010. [DOI] [PubMed] [Google Scholar]
  2. Cooper R. A. Seeking a balanced physician workforce for the 21st century. JAMA. 1994 Sep 7;272(9):680–687. [PubMed] [Google Scholar]
  3. Feil E. C., Welch H. G., Fisher E. S. Why estimates of physician supply and requirements disagree. JAMA. 1993 May 26;269(20):2659–2663. [PubMed] [Google Scholar]
  4. Mulhausen R., McGee J. Physician need. An alternative projection from a study of large, prepaid group practices. JAMA. 1989 Apr 7;261(13):1930–1934. doi: 10.1001/jama.261.13.1930. [DOI] [PubMed] [Google Scholar]
  5. Schwartz W. B., Sloan F. A., Mendelson D. N. Why there will be little or no physician surplus between now and the year 2000. N Engl J Med. 1988 Apr 7;318(14):892–897. doi: 10.1056/NEJM198804073181405. [DOI] [PubMed] [Google Scholar]
  6. Sheldon G. F. Graduate medical education: issues for the 21st century. Am J Surg. 1991 Feb;161(2):294–299. doi: 10.1016/0002-9610(91)91147-b. [DOI] [PubMed] [Google Scholar]
  7. Sheldon G. F. Recruitment and selection of the "best and brightest". Ann Thorac Surg. 1993 May;55(5):1340–1344. doi: 10.1016/0003-4975(93)90086-w. [DOI] [PubMed] [Google Scholar]
  8. Weiner J. P. Forecasting the effects of health reform on US physician workforce requirement. Evidence from HMO staffing patterns. JAMA. 1994 Jul 20;272(3):222–230. [PubMed] [Google Scholar]
  9. Weiner J. P. The demand for physician services in a changing health care system: a synthesis. Med Care Rev. 1993 Winter;50(4):411–449. doi: 10.1177/002570879305000403. [DOI] [PubMed] [Google Scholar]
  10. Whitcomb M. E., Desgroseilliers J. P. Primary care medicine in Canada. N Engl J Med. 1992 May 28;326(22):1469–1472. doi: 10.1056/NEJM199205283262205. [DOI] [PubMed] [Google Scholar]

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