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An Analysis of Change in Physicians' Work Load and Income

William B. Schwartz, MD; Daniel N. Mendelson

JAMA. 1990;263(4):557-560.

Abstract
Analysis of physicians' work patterns and income between 1982 and 1987 provides strong evidence that the demand for physicians' services has risen at least as quickly as physician supply. Aggregate hours spent by US physicians who provide patient care rose by 21%, and aggregate real net income rose by more than 30% during a period in which the supply of physicians grew by only 16%. The aggregate number of visits rose by only 9%, indicating that the time spent per patient encounter rose sharply, presumably as a result of technological change and the increased complexity of care. Recently released data for 1988 are consistent with these trends. Our findings are inconsistent with the prediction by the Graduate Medical Education National Advisory Committee that there would be a large physician surplus by the year 1990. Moreover, if the upward trend in demand for physicians' services continues, as seems probable, a physician surplus should not develop in the foreseeable future. Only extensive rationing of beneficial services would be expected to alter this projection.

(JAMA. 1990;263:557-560)

Author Affiliations
From the Department of Medicine, Tufts University School of Medicine. Boston, Mass.

Footnotes
The opinions and conclusions expressed herein are solely those of the authors and should not be construed as representing the opinions or policies of The Robert Wood Johnson Foundation, Princeton, NJ.

Reprint requests to Tufts University School of Medicine, 136 Harrison Ave, Boston, MA 02111 (Dr Schwartz).

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