The Impending Pediatric ‘Surplus’: Causes, Implications, and Alternatives

Abstract

The supply of pediatricians is increasing much more rapidly than the number of children in the United States. Between 1978 and 1990, the number of pediatricians will grow from approximately 26,000 to between 45,000 and 50,000, while the number of children will remain relatively constant. Although published standards vary widely, it appears certain that the forthcoming supply of pediatricians and family physicians will greatly exceed even the most generous estimates of the need for child health physicians. The recent work of the Graduate Medical Educational National Advisory Committee (GMENAC) has focused attention on the problem of physician oversupply. That panel estimates that by 1990 more than one of every eight pediatricians will be unnecessary and has recommended that even larger surpluses be allowed to develop. Determining whether the future supply will constitute a surplus raises issues for pediatrics that include not only the numbers, but also the proper balance of generalists, the role of family physicians and nurse practitioners, and trends in geographic preferences. Facing these issues will require a thorough analysis of child health needs to provide an adequate basis for making decisions about the number and appropriate training of child health care practitioners in the future.