A Pyramid Model of Health Manpower in the 1980s

Abstract

In little more than a decade, the problems and issues relating to the supply of, and demand for, skilled health manpower in the United States have shifted dramatically. Where the key words in the late 1960s were "shortage," "crisis," and "expansion of training capacity," the major concerns on the threshold of the 1980s are "oversupply," "overtraining," and "costs." Federal policy relating to health manpower is rapidly changing from attempts to increase manpower supply to efforts to contain expansion. This article presents a graphic representation of this change, along with projections for the future. Three stages of supply/demand are graphically depicted: Stage I represents the supply-deficit situation of the past; Stage II symbolizes a state of supply/demand balance; and Stage III represents the oversupply situation which seems imminent in many health manpower categories. Some suggestions for possible actions to prevent unlimited "might makes right" solutions to oversupply problems, and assessments of the results which might be expected, are presented.

Physician autonomy in the Federal Republic of Germany, Great Britain and The United States

“…17-19), though, more recently, nurses may be found as members of an institution's executive management team (Clifford, 1985, p. 28). On clinical matters too, there is evidence that increasing professionalization amongst nurses is occurring (McTernan and Leiken, 1982) and that increasing conflict with physicians is resulting (Silver, 1984).…”

Occupational Therapy’s Challenge: Caregiving and Research

“…Another economic issue, articulated by McTernan and Leikan (5), is that of supply and demand of health personnel. In the 1960s there was a critical shortage in health staffing; this led to the support of training programs.…”

“…When oversupply exists the greatest pressure will be on the middle trained service providers (5). The larger populated technical groups will apply pressure from below, and the smaller, more powerful physician groups will apply pressure from above in the pyramid analogy set forth by McTernan and Leikan (5). Nonphysician practitioners will be seen as competition for the limited health care dollars.…”

“…Nonphysician practitioners will be seen as competition for the limited health care dollars. The Graduate Medical Education National Advisory Committee has directed the government to hold the number of nonphysician providers to their present levels (5). However, mere expansion of physician supplies fails to satisfy the cost/benefit problem; physicians are likely to continue to charge the same (higher) rates.…”

Research: An Economic Imperative

“…In this regard, McTernan and Leiken (1982) have provided a useful model of how the forces of supply and demand are likely to affect the country's skilled health manpower during the 1980s. They concluded that first-level health professionals (those educated at the bachelor's and master's level of entry for practice) will be subjected to great pressure as the oversupply of health professionals occurs.…”