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At least 289 records · Page 16Linked to original sources

PubMed1997

Workforce projections for emergency medicine: how many emergency physicians does the United States need?

OBJECTIVE: To mathematically model the supply of and demand for emergency physicians (EPs) under different workforce conditions. METHODS: A computer spreadsheet model was used to project annual EP workforce supply and demand through the year 2035. The mathematical equations used were: supply = number of EPs at the beginning of the year plus annual residency graduates minus annual attrition; demand = 5 full-time equivalent positions/ED x the number of hospital EDs. The demand was empirically varied to account for ED census variation, administrative and teaching responsibilities, and the availability of physician extenders. A variety of possible scenarios were tested. These projections make the assumption that emergency medicine (EM) residency graduates will preferentially fill clinical positions currently filled by EPs without EM board certification. RESULTS: Under most of the scenarios tested, there will be a large deficit of EM board-certified EPs well into the next century. Even in scenarios involving a decreasing "demand" for EPs (e.g., in the setting of hospital closures or the training of physician extenders), a significant deficit will remain for at least several decades. CONCLUSIONS: The number of EM residency positions should not be decreased during any restructuring of the U.S. health care system. EM is likely to remain a specialty in which the supply of board-certified EPs will not meet the demand, even at present levels of EM residency output, for the next several decades.

Computer Simulation↗

PubMedDate not supplied

Building a home healthcare workforce to meet the quality imperative.

The 1990s brought shifts in the organization and financing of healthcare services and changes to the nursing workforce as well. These changes were pronounced in home healthcare, where growth in service use between 1988 and 1996 was followed by sharp contractions in home healthcare users and visits after changes in Medicare reimbursement policy in 1997. This article examines how the nursing workforce has responded to these changes, explores the challenges posed by the nursing shortage, highlights the gap in knowledge of the staffing-outcomes relationship and its implications for quality, and offers recommendations on ways to improve care.

Ambulatory Care↗

PubMed2003

Implications of a needs-based approach to estimating psychiatric workforce requirements.

The author reviews a needs-based approach to estimating psychiatric workforce requirements that entails five determinations: (1) number of people with mental health problems, (2) number of people needing mental health treatment, (3) number of people needing psychiatric treatment, (4) amount of psychiatric time required to meet patient needs, and (5) amount of time psychiatrists have available to provide direct patient care. Questions, issues, and strategies raised by the needs-based approach are outlined. The author suggests that only a coordinated, carefully orchestrated effort among national psychiatric organizations will ensure that the future psychiatric workforce is adequate to meet the needs of the mentally ill.

Education, Medical↗

PubMed2004

Workforce information on addiction psychiatry graduates.

OBJECTIVE: The aim of this paper is to report workforce information about graduates from accredited training programs in addiction psychiatry. METHODS: As of June 30, 2002 there were 44 ACGME-accredited addiction psychiatry programs. The author asked the directors of these programs to complete a workforce survey about their graduates. RESULTS: Seventy-three percent of program directors responded, providing information about 186 addiction psychiatrists. Forty-one percent of the graduates were employed in academic settings. Sixty-four percent of graduates employed in clinical settings dealt primarily with substance abuse patients. A majority of respondents described graduates as satisfied with compensation packages. CONCLUSION: Addiction psychiatry offers opportunities in a variety of settings that allow new graduates to utilize their subspecialty training.

Accreditation↗

PubMed2002

Workforce planning and community children's nurses: it's all in the advertisements.

This paper outlines a study exploring job advertisements for community children's nurses (CCNs). A post-structural approach was taken to illuminate the development of community children's nursing services (CCNS) and the profile of characteristics, skills and caseload within a workforce-planning context. An analysis of 100 advertisements looked at title, skills, caseload, qualifications and evolving roles. The analysis comprised an initial quantitative descriptive account of data, followed by further analysis of the text using thematic analysis and coding. The skills identified were compared to those identified by Proctor et al. (1999). The most commonly occurring skills were interpersonal (35%), multi-professional team working (33%), clinical (28%), management (18%) and leadership (16%). The analysis was limited, but provides a unique insight into employers' perceived needs in providing CCN services, evolving titles and roles and could inform practitioners, contribute to service evaluation, future service provision and workforce planning.

Advertising↗

PubMed1995

Head and neck surgery workforce in the year 2014.

The head and neck surgery workforce in the United States over the next 20 years is of significant interest to physicians, patients, and others. Using election to fellowship in the American Society for Head and Neck Surgery or the Society of Head and Neck Surgeons, or both, as the criteria for designation as a head and neck surgeon, a mathematical model was designed to project the growth of the head and neck surgery workforce through the year 2014. The current combined active membership of the two societies was analyzed to determine the impact of age distribution on this model. The paradigm assumes 30 new head and neck surgeons each year and includes the appropriate mortality rate for each cohort. Based on this model, the total number of head and neck surgeons should decrease slightly from 1109 in the year 1994 to 1028 in the year 2014. A steady-state supply of head and neck surgeons is therefore predicted.

Adult↗

PubMed2005

An international review of the long-term care workforce: policies and shortages.

The developed world's population is aging, due to trends of increased life expectancies and decreased fertility rates. These trends are predicted to increase demand on long-term care services. At the same time, the long-term care workforce is in shortage in most of the developed world. Moreover, such shortages are expected to increase due to parallel socio-demographic factors. The increase in demand for longterm care, coupled with shortage in supply of care workers, has promoted some attention from policymakers. The current paper provides an international review of institutional arrangements for long-term care in different developed countries and in particular explores different strategies used or proposed to resolve the shortage in the long-term care workforce.

Aged↗

PubMed2000

The structure of the dental workforce in the 21st century.

Graham Try (page 9) has suggested that the UK is heading towards dentist shortage. This paper picks up the story from there, speculating on how a shortage of dentists might stimulate changes in working methods. The market place will look for workforce configurations which make business sense at practice level and which deliver services in a form which patients find helpful and convenient. Although some dental procedures can be carried out by people with less training than dentists, this may not contribute to economic efficiency and could make the customer service experience less appealing. Changes in the structure of the workforce may therefore be less radical than has sometimes been suggested. Much depends on how decision-making and regulatory processes evolve. It seems likely that local and practice level decision-making will grow at the expense of central planning.

Decision Making, Organizational↗

PubMedDate not supplied

Fighting hand to hand over physician workforce policy.

A vexing problem in health policy is getting the right number of physicians in the right specialties in the right locations at the right time. I examine market and public planning approaches to getting the number "right." After discussing the basic premises of the invisible hand of the market and the heavy hand of government regulation, I apply these concepts to a review of the past century of U.S. physician supply and workforce policy. I conclude by examining recent health system trends that make clear the need for a firm regulatory grasp on physician workforce policy.

Health Care Sector↗

PubMedDate not supplied

Trends in the physician workforce, 1980-2000.

Over the past twenty-five years the nation has struggled with a series of physician workforce issues: determining the appropriate number of physicians needed and the appropriate number to produce; the role of international medical school graduates; the mix of primary care and non-primary care physicians; efforts to increase the number of underrepresented minorities in medicine and the supply of physicians in rural areas; and the impact of the growing number of female physicians. This paper documents physician workforce trends over the past twenty years, especially as they relate to these issues.

Adult↗

PubMedDate not supplied

The public health workforce.

Defining the public health workforce and specifying its performance requirements present equal challenges as the nation anticipates public health needs for the twenty-first century. The core group of professionals employed by government public health agencies works in close partnership with a wide range of public, private, and voluntary organizations. The wider circle includes almost all physicians, dentists, and nurses, plus many other health, environmental, and public safety professionals. The task of ensuring that this workforce is prepared with skills and knowledge to face both identified and emerging public health challenges is immense.

Education, Public Health Professional↗

PubMedDate not supplied

End-of-life care at academic medical centers: implications for future workforce requirements.

The expansion of U.S. physician workforce training has been justified on the basis of population growth, technological innovation, and economic expansion. Our analyses found threefold differences in physician full-time-equivalent (FTE) inputs for Medicare cohorts cared for at academic medical centers (AMCs); AMC inputs were highly correlated with the number of physician FTEs per Medicare beneficiary in AMC regions. Given the apparent inefficiency of current physician practices, the supply pipeline is sufficient to meet future needs through 2020, with adoption of the workforce deployment patterns now seen among AMCs and regions dominated by large group practices.

Academic Medical Centers↗

PubMed2001

American Academy of Pediatrics: Financing graduate medical education to meet pediatric workforce needs.

This statement reviews the current system of funding for graduate medical education (GME) in the United States and evaluates the potential of alternative GME funding mechanisms, including a portable authorization system, to meet future pediatric workforce needs. It addresses key issues relating to the financing of GME: Medicare direct medical education (DME) and indirect medical education adjustment (IMEA) payments, an all-payer GME trust fund, and a market mechanism to distribute GME funds for both core pediatric and pediatric subspecialty education. In a concluding series of recommendations, the statement calls for changes to the current system of GME funding to ensure the production of a pediatrician workforce that will be able to meet the future needs of infants, children, adolescents, and young adults.

Academies and Institutes↗

PubMed2005

The pediatric subspecialty workforce: public policy and forces for change.

Policy has not adequately addressed the unique circumstances of pediatric subspecialties, many of which are facing workforce shortages. Pediatric subspecialties, which we define to include all medical and surgical subspecialties, are discrete disciplines that differ significantly from each other and from adult medicine subspecialties. Concerns about a current shortage of pediatric subspecialists overall are driven by indicators ranging from recruitment difficulties to long wait times for appointments. The future supply of pediatric subspecialists and patient access to pediatric subspecialty care will be affected by a number of key factors or forces for change. We discuss 5 of these factors: changing physician and patient demographics; debt load and lifestyle considerations; competition among providers of subspecialty care; equitable reimbursement for subspecialty services; and policy to regulate physician supply. We also identify issues and strategies that medical and specialty societies, pediatric subspecialists, researchers, child advocates, policy makers, and others should consider in the development of subspecialty-specific workforce-policy agendas.

Career Choice↗

PubMed2006

Addressing health care disparities and increasing workforce diversity: the next step for the dental, medical, and public health professions.

The racial/ethnic composition of our nation is projected to change drastically in the coming decades. It is therefore important that the health professions improve their efforts to provide culturally competent care to all patients. We reviewed literature concerning health care disparities and workforce diversity issues--particularly within the oral health field--and provide a synthesis of recommendations to address these issues. This review is highly relevant to both the medical and public health professions, because they are facing similar disparity and workforce issues. In addition, the recent establishment of relationships between oral health and certain systemic health conditions will elevate oral health promotion and disease prevention as important points of intervention in the quest to improve our nation's public health.

Cooperative Behavior↗

PubMed2001

Continuing-education needs of the currently employed public health education workforce.

OBJECTIVES: This study examined the continuing-education needs of the currently employed public health education workforce. METHODS: A national consensus panel of leading health educators from public health agencies, academic institutions, and professional organizations was convened to examine the forces creating the context for the work of public health educators and the competencies they need to practice effectively. RESULTS: Advocacy; business management and finance; communication; community health planning and development, coalition building, and leadership; computing and technology; cultural competency; evaluation; and strategic planning were identified as areas of critical competence. CONCLUSIONS: Continuing education must strengthen a broad range of critical competencies and skills if we are to ensure the further development and effectiveness of the public health education workforce.

Credentialing↗

PubMed1994

Avoiding litigation after a reduction in workforce.

Healthcare organizations can avoid litigation after a reduction in workforce by observing Federal and state laws that protect employees, by documenting why and how the reduction will be carried out, and by training healthcare managers to terminate employment properly. Careful planning and scrupulous execution of a reduction-in-workforce plan can prevent costly lawsuits.

Employment↗

PubMed1996

Business as usual? Changes in health care's workforce and organization of work.

Major changes are occurring in the health care workforce and organization of work. Such changes include, for example, a shift in workforce composition from specialists to generalists in medical care, as well as a shift from autonomous work performance to work performed in teams. This article provides a survey of such major changes. It identifies patterns of change and examines their causes. Further, we raise questions about the implications of these changes for practice and research in the health care field.

Contract Services↗