Synopses & Reviews
"Will there be a doctora good doctorwhen I need one?"This is the bedrock health care concern for Americans, encompassing as it does additional concerns about affordability, accessibility, efficiency, and specialty expertise.
Richard M. Scheffler brings an economist's insight to the question, showing how shifts in market power underlie the changes we have seen in the health workforce and how they will affect the future availability of doctors. Predicting the "right" ratio of doctors to population in the future is only a small piece of the puzzle, and one that has been the subject of much forecasting, and little agreement, over the past several decades.
In this concise and readable analysis, Scheffler goes beyond the guessing game to demonstrate that today's health care system is the product of financial influences in both the policy realm and on the ground in the offices of medical centers, HMOs, insurers, and physicians throughout America. He shows how factors such as physician income, medical training costs, and new technologies affect the specialties and geographic distribution of doctors. Scheffler then brings these findings to bear on a set of predictions for the U.S. and international physician workforce that extend five and ten years into the future. As part of his vision of tomorrow's ideal workforce, he offers a template for enhancing the efficiency and cost-effectiveness of the health care system overall.
In the groundbreaking second half of the book, the author, a health policy expert himself, tests his ideas in conversations with leading figures in health policy, medical education, health economics, and physician practice. Their unguarded give-and-take offers a window on the best thinking currently available anywhere. Finally, Scheffler combines their insights with his own to offer observations that will change the way health care's stakeholders should think about the future.
Review
"Scheffler has the ability to present economic theory and data in an entertaining fashion that both informs and compels us to examine our prior beliefs about the complex question of whether the United States has a shortage or surplus of doctors.... This easy-to-read, important volume is essential reading for everyone interested in our nation's need to effectively reform health care."Psychiatric Services
Review
"Today's medical students will help mold the health care delivery system of and in the future. It follows that they should read this exceedingly readable volume and consider its implications for they must understand the issues in order to participate effectively in the design of the system in which they will work to advance their patients' and the nation's health."Rashi Fein, Professor of Medical Economics, Emeritus, Harvard Medical School
Review
"Questions about how many and what kinds of doctors the country needs are front and center in the current debate about health care reform. Everyone interested in the future of our healthcare system, especially students planning careers in the health professions, would benefit from engaging this very readable book."Jordan J. Cohen, MD, Professor of Medicine and Pubic Health, George Washington University, and President Emeritus, Association of American Medical Colleges
Review
"Scheffler concludes that a modest increase in physician supply (10-20 percent) is justified, but that the organization of practice and the orientation of incentives are more important in the long run. What is truly unusual and useful about the book are the 27 commentaries, a refreshingly informal set of conversations with more than a score of knowledgeable physicians and academic experts in the field."CHOICE
Review
"Physicians have been and continue to be central to the delivery of medical services. Physician supply affects access to care and also physicians' willingness to participate in managed care plans and new delivery systems. Is There a Doctor in the House? is a thoughtful and timely discussion of the adequacy of the supply of physicians in coming years, and it should be of value to those with a special interest in health care workforce policy." —Paul Feldstein, Paul Merage School of Business, University of California at Irvine
Synopsis
This data-driven book analyzes factors that will improve the efficiency and quality of the American health care delivery system through the lens of physician supply in an era of managed care. Presenting policy recommendations and a broad range of perspectives from conversations with experts in health economics, medical education, and health policy, Scheffler's work makes accessible a critical and complex area of health care.
About the Author
Richard M. Scheffler is Distinguished Professor of Health Economics and Public Policy at the University of California, Berkeley and holds the Chair in Healthcare Markets and Consumer Welfare endowed by the Office of the Attorney General for the State of California.