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September 6, 1995

Managed Health CareImplications for the Physician Workforce and Medical Education

Author Affiliations

From the Council on Graduate Medical Education, Rockville, Md.
Programs in Health Management, Center for Health Sciences, Department of Preventive Medicine, University of Wisconsin, Madison; Hospital Services Division, Country Villa Services Corporation, Culver City, Calif; Strategic Health Systems, Harrisburg, Pa; associate chief medical director for academic affairs, Department of Veterans Affairs, Washington, DC; American Medical Student Association, and medical resident, San Francisco, Calif.; Division of General Medicine, Brigham & Women's Hospital, Boston, Mass; Thomas Jefferson University, Philadelphia, Pa; University of Texas Medical Branch, Galveston; Louisiana State University School of Medicine, New Orleans; professor and chairman, Department of Family and Community Medicine, University of Missouri-Columbia; AFL-CIO Service Employees, Washington, DC; manager of health care plans, General Motors, Detroit, Mich; executive vice president, Midwestern University, Olympia Fields, Ill; dean, College of Medicine, University of Tennessee, Memphis; director, Bureau of Health Professions, Health Resources and Services Administration, Public Health Service, Rockville, Md; deputy director, Bureau of Policy Development, Health Care Financing Administration, Baltimore, Md; director, Division of General Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Md.; executive secretary of the Council and director, Division of Medicine; chief, Special Projects and Data Analysis Branch; deputy executive secretary and deputy chief, Special Projects and Data Analysis Branch; staff liaison, Physician Workforce and Managed Care Issues and project officer for the development of the Council's Sixth Report; operations research analyst; staff liaison, Women and Medicine Report; associate director, Division of Medicine for Policy and Planning; staff liaison, Geographic Distribution Issues

JAMA. 1995;274(9):712-715. doi:10.1001/jama.1995.03530090044020

THE COUNCIL on Graduate Medical Education (COGME) was authorized by Congress in 1986 to provide an ongoing assessment of physician supply trends and to recommend appropriate public and private sector efforts to better match the physician workforce in composition and competencies to health care needs. The Council's Third Report, released in 1992, concluded that generalist and minority physician shortage, specialist physician surplus, and poor geographic distribution would hinder strategies to provide quality and affordable health care to all Americans.1 Since then, the rapid growth of managed health care prompted COGME to examine its impact on the physician workforce and medical education.

A broad spectrum of opinion was solicited from a report advisory group and from representatives from the managed care, medical education, and medical professional communities. This article summarizes the findings of COGME's Sixth Report. Further rationale and documentation are provided in the full report, in its citations, and

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