To the Editor. —
Drs Mulhausen and McGee1 purport to show a significant projected oversupply of certain specialties based on an analysis of current health maintenance organization (HMO) staffing levels. One of these specialties is orthopedic surgery, which they feel will be grossly overpopulated within the next 20 years based on their modeling. There is a severe problem with their methods for making this assessment. While they have stated that they do attempt to look at contract and referred-out data, they present none of this and admit backhandedly that it is really not available. It is both my personal experience from practice as well as my observation of many orthopedic surgeons that full-time orthopedic surgeons employed by HMOs are at a level dramatically less than what the HMOs would like. Furthermore, even those who have contractual arrangements are in relatively short supply. A recent perusal of the Journal of Bone
Oreck SL. Physician Need. JAMA. 1989;262(9):1184. doi:10.1001/jama.1989.03430090046018
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