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PEDIATRICS Vol. 113 No. 4 April 2004, pp. 918-919

COMMENTARY

Projecting, Predicting, Shaping: The Challenge of Workforce Models

Carol D. Berkowitz, MD

Department of Pediatrics
Harbor-UCLA Medical Center
Torrance, CA 90509
Department of Pediatrics
David Geffen School of Medicine at UCLA
Los Angeles, CA 90095

Abbreviations: GME, graduate medical education

The first 20% of the full text of this article appears below.

Hollywood loves creating movies in which the hero has seen the future and then acts to prevent an apocalyptic outcome by manipulating events leading up to it. At the end, the audience may be left debating the age-old question: Can you change the future?

The goal of Shipman et al1 is less dramatic than that of the silver screen, and an oversupply of general pediatricians can hardly be viewed as apocalyptic. The authors are quite cautious, in fact, and don’t pretend to "predict" the future but rather to "project" it, that is to project workforce supply based on current available data and a refined projection model. But how well can one project the future workforce or manipulate the pipeline to change it?

Workforce projections are not new, although methodologies and factors influencing the analyses have varied. One report suggested that it takes 50 years to stabilize the physician-to-population ratio; thus, manipulating the future is definitely slow and problematic.2 How successful were past prophesies in either predicting or modifying the future? Let us examine 3 specific areas: the supply of pediatric generalists versus subspecialists; predictions about job opportunities for other specialties such as anesthesiology; and attempts to remedy physician maldistribution.

In the early 1990s, . . . [Full Text of this Article]

Address correspondence to Carol D. Berkowitz, MD, Harbor-UCLA Medical Center, 1000 West Carson St, Box 437, Torrance, CA 90509. E-mail: carolb@pol.net