Scientific workforce. Viewed from 1986, it's mostly downhill.
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The authors designed survey research to assess accredited master of public health (MPH) programs with health education concentrations. A Web-based survey was distributed to program directors and was used to collect characteristics of program faculty, students, graduates, internships, employment, and competency development. Results indicate that students and graduates are diverse; 72% of students complete internships and 61% of graduates work in government or community public health-related agencies; 98% of faculty hold a doctoral degree and 67% have at least one degree from an accredited public health school or program; and 85% of programs build competencies in most of the Institute of Medicine-suggested areas. The authors conclude that accredited MPH programs with a concentration in health education train diverse public health practitioners highly likely to work in a government or community public health agency with competencies to enhance public health.
Global changes in the economies of most developed nations have impacted the way healthcare is organized, even within largely public systems, and the working conditions of healthcare workers. Since the acceleration of globalization in the 1970s, service-sector workers in developed nations have faced high unemployment, increased skill requirements for most jobs, and a rise in non-traditional work arrangements. These secular shifts in service-sector labor markets have occurred against the background of an erosion of the welfare state and growing income inequality. As well, many healthcare systems, including Canada's, were severely downsized and restructured in the 1990s, exacerbating the underlying negative secular trends in the service sector, and worsening the working conditions for many healthcare workers. Globalization has altered the labor market and shifted working conditions in ways that have been unfavorable to many healthcare workers.
PURPOSE: A survey was designed to determine accurately the number of full-time equivalent medical oncologists in the United States, to determine how medical oncologists in different work settings divide their professional activities, and to determine whether medical oncology represents a primary care specialty in the minds of practicing oncologists. METHODS: A questionnaire was mailed to the 4,239 members of the American Society of Clinical Oncology (ASCO) who identified themselves as medical oncologists or hematologists/oncologists and were current residents of the United States. Follow-up letters, which included a second copy of the questionnaire, were sent to nonresponders. A third mailing, followed by a telephone reminder, was sent to a randomly selected subset of 300 nonresponders to be certain that the initial responders were similar in practice patterns and attitudes to those individuals who had not initially completed the survey. RESULTS: A total of 2,540 physicians responded to the first mailing and an additional 187 to the second (64% response rate); a further 196 individuals who were directly contacted completed the survey document. Practitioners appear to see 160 to 200 different patients per month and to devote approximately 72% of their time to patient care activities. Research and teaching comprised only 3% to 4% of professional time for physicians in private practice or Health Maintenance Organization (HMO) settings, in contrast to 16% for those who worked in community hospitals. Medical oncologists frequently serve the role of principal care giver while patients are undergoing cancer treatment. However, medical oncologists devote minimal time providing primary care services to patients and, if required to increase their clinical volume, would prefer to care for more cancer patients than enhance their primary care activities. It is estimated that the present full-time equivalent number (ie, the conglomorate number of oncologists based on 100% professional effort devoted to clinical care) of medical oncologists is approximately 3,600 individuals. This translates into 1.8 medical oncologists per 100,000 adult Americans. CONCLUSION: The medical oncology community devotes the majority of its time to providing oncologic patient care and does not provide or appear to wish to provide what the public defines as primary care. The survey estimate of 1.8 medical oncologists per 100,000 adult Americans is in close accord with HMO estimates of the number of desired oncologists. Consequently, the supply appears consistent with the anticipated demand. There does not appear to be an oversupply of medical oncologists in the United States.
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OBJECTIVE: To provide a current profile of the practice of child neurology, report the attitudes of child neurologists toward practice, and analyze the supply of child neurologists. METHODS: In March 2002, a questionnaire was sent to all active members of the Child Neurology Society (n = 1,051) and to nonmember physicians under age 70 who listed child neurology as a primary or secondary specialty on the American Medical Association Masterfile (n = 433). The response rate was 65%. Eligibility criteria were then applied to arrive at the sample of main specialty in child neurology working at least 20 hours per week in patient care. The final population was 604. Differences in practice characteristics were tested by practice type, and the number of full-time patient care child neurologists was projected by extrapolating to nonrespondents. RESULTS: There are 904 full-time patient care child neurologists in the United States and 1.27 per 100,000 children. Career satisfaction is 90%, yet no growth in the supply is projected over the next 20 years. Wait times for an appointment average 53 and 44 days for a new and return visit, with longer wait times in university settings. Average annual income is 151,000 dollars. CONCLUSION: The practice characteristics of child neurologists suggest that the specialty will be challenged to meet patient demands.
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