Posting date: March 15, 2005

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Health Affairs, 10.1377/hlthaff.w5.111
Copyright © 2005 by Project HOPE

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Adding More Specialists Is Not Likely To Improve Population Health: Is Anybody Listening?

¹ Robert Phillips is director of the Robert Graham Center in Washington, D.C.
² Martey Dodoo is an economist at the Robert Graham Center in Washington, D.C.
³ Larry Green is the senior scholar in residence at the Robert Graham Center.

^*Corresponding author.

Abstract

Before a shortage of physicians, and particularly subspecialists, in the United States is declared, it is worth reviewing the considerable evidence that calls into question whether further specialization automatically improves health. Barbara Starfield and colleagues' latest research reveals, again, that having more specialists may not be a good thing. The current workforce functions well as an economic engine, but continued emphasis on market demand will likely widen disparities in workforce distribution and population health. The resurgence of interest in shaping the future physician workforce should lead to purposeful choices about what we want them to do and the outcomes we expect.

Key Words: Access To Care, Consumer Issues, Health Promotion/Disease Prevention, Health Reform, International Issues, Physicians, Workforce Issues

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