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Managing physician resources: East and West.

AIM
To examine the current physician supply in western countries, Central and Eastern Europe (CEE), and the Newly Independent States (NIS) of the former Soviet Union. To assess the current management of physician resources in these regions and the potential for their future management.


METHODS
Description and analysis of current physician to population ratios, graduating physician to population ratios, and specialty distribution of physicians.


RESULTS
Maldistribution of physician resources, both by specialty and geographically, exists in the East and the West. The management of physician resources varies widely in the West, from virtually no attempts to manage the resources in the United States to increasingly regulatory methods in Canada. The CEE and the NIS face problems in managing physician resources as the movement to primary care continues. At the same time, changes in payment mechanisms create new and often perverse incentives for physicians, in addition to the problems inherited from the centrally managed systems.


CONCLUSIONS
Countries in the East and West face challenges in managing physician resources to overcome the current maldistribution of those resources. Efforts must be made to make the medical education system responsive to the future physician supply needs. This is especially true in the East where health systems continue the transition from centrally managed to more market based systems.