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Strategies to achieve balance in the physician workforce.

Issues of physician training and of the characteristics of the physician workforce have been debated for many decades. Over the past two years, the dialog has centered on a single proposal: that half of all US medical graduates should become primary care physicians: the so called "50% solution" (1). This proposal, initially developed by the Committee on Graduate Medical Education (COGME) (2), was incorporated into Congressional bills in both the House and the Senate. However, none of these bills were successful in the 103rd Congress. This allows an opportunity to reexamine the workforce issues, to analyze the data and draw fresh conclusions. To facilitate that process, five fundamental questions will be addressed: (A) how many physicians are there today; (B) how many are needed; (C) how many will be needed in the future; (D) how many are there likely to be in the future; and (E) what will be the future mix of primary care physicians and specialists?