US medical workforce expansion plan criticized in the BMJ

David Goodman of Darthmouth Medical School in New Hampshire, USA wrote an editorial piece criticizing the current plan in the US to expand medical training. He argues that "expanding the medical workforce is unlikely to be cost effective or produce better outcomes for patients". He cites Jonathan Weiner of Johns Hopkins University that the cross country analysis that the current level may not be too few. According to Weiner, there are other ways to spend money more efficiently to improve health situation in the US. The use of other heatlh care cadres and the way health system is managed could play important roles.

click for: Goodman's article, Weiner's article

Summary points from Weiner's analysis based on OECD data
  • Above a certain threshold, there is little evidence that more doctors add to health of population
  • Many countries, US regions, and health maintenance organisations provide superior care with fewer doctors per person than the current US national ratio
  • Forecasts of a future US doctor shortage do not adequately consider the availability of other clinical providers
  • Information technology and preventive healthcare may increase productivity and decrease patient demand
  • The billions to be spent on expanding US medical training would be better spent on meeting the needs of citizens without access to basic care


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