Does Increased Physician Supply Affect Quality of Care?

Prologue: One unsettling question facing the U.S. health care system today is whether, amidst the flurry of cost cutting, the quality of medical care is beginning to suffer. There is no real consensus about what good care is, but various organizations are actively striving to find out A crucial question in this determination of quality is how the growing number of physicians will affect it; since physicians are the basic building block for medical care, how they respond to changes around them is important Do more physicians mean that they will provide better care because they are more accessible, have more time, and must compete more aggressively? Or do more physicians mean extra lab tests, unnecessary surgery, and too many office visits for the patient? James Perrin and Joseph Valvona attempt to answer these questions through a review of past research and a new analysis of their own. They assert that simply increasing the number of physicians will not improve the quality of health care. While doing so may enhance overall access to care or provide a safety net for potential medical disasters such as AIDS , improving quality should be achieved through other means, the authors say. James Perrin, a pediatrician educated at Case Western Reserve University and at the University of Rochester, is director of Ambulatory Care Programs and General Pediatrics for the Children's Service at Massachusetts General Hospital in Boston. Previously, he resided at Vanderbilt University where he ran the Primary Care Center. Joseph Valvona, a research associate at the Vanderbilt Health Policy Center, holds a master of science degree in genetics from the University of Arizona and a master's degree in business from Vanderbilt Perrin and Valvona have worked on a number of studies together including one on the diffusion of surgical technologies. This article is drawn from a paper presented at a Vanderbilt University Health Policy Symposium on graduate medical education.