The year is 1959, and Mr. Scott has had a migraine headache for the past few weeks and so he drives to the local Potsdam Hospital. The poignant antiseptic smell fills his nostrils as he steps unto the polished hospital floor but what catches his eye is the large number of people waiting in the lounge. Mr. Scott patiently stands behind the long line of people to sign the needed forms to be seen by the physician. An hour and a half passes, and it is finally his turn to see the receptionist. He looks at the woman behind the counter in the bright white uniform and asks, “Is it always like this?” The woman replies in a weary but irritated tone “It was not this hectic until Dr. Johnson and Dr. ...view middle of the document...
There was fear of rapid population growth projections with disproportionate increases of the young and elderly. These two populations statistically and historically utilize more health care than the average populace.
2. There was an increased per capita use of health care facilities. This was spurred by numerous factors. The first was improved living standards that brought higher life expectancy and lower infant mortality. An increase in health care facilities and transportation systems, both private and public, increased the number of patients to the hospitals. The public educated themselves; thus they knew the signs and symptoms of when they needed to seek medical help. This knowledge spawned more frequent visits. Finally, the wider use of medical insurance (private, as well as Medicare and Medicaid) gave greater numbers of patient’s access to healthcare.
3. There were large numbers of general practitioners that shifted into research, specialization, industry, and other fields. One report concluded:
Although the physician rate per 100,000 had remained fairly constant for the 30 years proceeding the report and was 141 per 100,000 in 1959, the percentage of physicians serving as primary care physicians, even including the new specialties of internal medicine and pediatrics, had decreased. Primary care physicians furthermore decreased in absolute numbers, making the ratio per 100,000 physicians much smaller.
Ettinger’s lecture on historical trends of physician placement further supported the belief that general practitioners shifted into specialization. She stated that hospitals developed and pushed training programs for specialization during World War II, and hospitals made it easier for specialists to see more patients with the aide of pre-screeners who in turn made specialists more productive and profitable than general practitioners. Because of these incentives, many general practitioners became specialized. In the 1960s, their utilization sharply declined. It was predicted they would become extinct.
To summarize points one through three, this government report was inaccurate in its projections. The population growth was over estimated and what really occurred was a shift of growth to the young and elderly populations. Second, there was not an overall shortage of physicians, but rather a decline in number per capita due to specialization . There were numerous published documents, including the above-mentioned 1959 Surgeon General’s report, which theorized there could be a shortage of physicians. Actually, the total number of physicians stayed the same; there was just a change of in the number of general practitioners. Evidence that this belief still remained until the early 1970's can be seen with a book that was published by Rashi Fein entitled The Doctor Shortage: An Economic Diagnosis. The shortage concept was a snowball of popular writings that ended up as beliefs. These small misconceptions helped develop a new medical profession...