Date of Award

4-8-2010

Document Type

Thesis

Abstract

With the passage of the new health care bill in March of this year, President Obama was able to promise health care coverage to millions of Americans (Health Reform, 2010). While this was a major step towards increasing the health of our nation, promise of coverage does not automatically equate with the promise of better health. Rather, the expanded coverage may more significantly correlate with expanded physician wait lists. As newly insured Americans attempt to make appointments, they may have a difficult time finding a physician who has the time to take them due to a shortage of available doctors. Our nation is currently facing an impending physician shortage that has already begun to erode parts of our physician workforce (AAMC, 2008). The shortage has manifested itself with particular force in the fields of primary care and general surgery. Primary care has seen a staggering decrease in student interest and the field is having a difficult time recruiting new physicians. The conditions in primary care have become dire enough to warrant attention of the national government (Health Reform, 2010). General surgery, while not in quite as desperate of a position, is also having difficulty filling residency positions and may be following down the path taken by primary care. These shortages have real effects not only on patients seeking medical attention and on health care reform efforts, but also on international communities and individual physicians (International, 2010; Gundersen, 2001) Shortages in the physician workforce are fundamentally linked to the choices of medical school students and physicians as they decide which specialty to pursue. The increased attractiveness of some specialties and unattractiveness of others causes an inadequate distribution of students across the many medical fields. Primary care and general surgery are both facing shortages because of a lack of interest in those specialties. In order to face problems associated with a physician shortage and respond to the issues of physician maldistribution, it is essential to understand what impacts medical career decisions and causes some specialties to be more appealing than others. Understanding the factors that guide the choices of students and physicians will help discern those factors that, when addressed, will be the most influential in closing the specialty gap. Thus, policy reform efforts must take into account the decision making process of students and physicians to best address the workforce maldistribution between specialties.

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