Planning and managing the physician workforce

This is a commentary on http://www.ijhpr.org/content/1/1/13 webcite.In any country the ability of persons to get the health care services they need depends upon the size, composition, and accessibility of that country's health care workforce and health care facilities. The country's supply of physicians is a subset of the overall health care workforce. In turn, the supplies of specific types of physician generalists and specialists are subdivisions of the total physician supply. Furthermore, within countries there tends to be large geographic variation in the distribution of the various elements of the health care workforce, which affects accessibility of services or certain types of services.It appears that each of the abovementioned issues is relevant in Israel. Recently, to address an apparent shortage of domestically trained and retained physicians, medical schools have been increasing their class sizes, and a new medical school has opened for the first time since 1974. There has also been concern that new graduates of Israeli medical schools are not choosing to train in fields such as internal medicine, general surgery, and anesthesiology, and concern about the tendency of physicians to locate centrally within the country rather than in the periphery. It is in that context that Weissman et al. have surveyed fifth year medical students, studied medical specialty considerations at that stage of their training, and pointed out the opportunity to influence their specialty considerations in the early stages of clinical training [1].Workforce assessment and planning efforts are complex. Although the issues I present below are generally applicable to developed countries, my examples come primarily from the United States. Within the U.S., workforce assessment and planning efforts are not only complex but highly controversial and sometimes politically sensitive. The controversies relate to the data sources, the methods of analysis, and whether approaches to addressing w