Feast or famine

BMJ 1997; 315 doi: (Published 08 November 1997) Cite this as: BMJ 1997;315:1241
  1. George Dunea
  1. attending physician, Cook County Hospital, Chicago, USA

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    For more than a century various interested parties have been arguing over how many doctors we need, and whether we have too many or too few. Should there be a glut in desirable areas so there can be trickle down to less attractive ones? Should you regulate numbers or let market forces decide? Perceptions on these points have varied over the years, and so have official health policies, because in fact medical education in the United States is tightly regulated by professional licensing bodies and heavily subsidised by the government.

    There seemed to be a shortage some 30 years ago. At the time even the rich often had to wait for weeks for a doctor's appointment. Whole counties …

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