Is anyone paying attention?

W ork force studies often reflect common prejudices , cost-saving philosophies, rumor and innuendo , but little data. An exception to this rule exists in the recently published Committee on Manpower of Pulmonary and Critical Care Societies (COMPACCs) study. 1 As I read it, there is a shortage of pulmonary and critical care specialists now and this shortage will get worse in the future. These conclusions are based on real survey data with excellent physician participation. This is no surprise to me, since I have some personal observations to back up these conclusions. In 28 years of training pulmonary fellows, I do not remember more than two who had any difficulty in finding a job. Mostly, the fellows were besieged with job offers. In reviewing the personnel services of this journal for the past 8 years, there are usually between 10 pages and 20 pages of advertisements for positions available as opposed to one or two total positions sought. In the 1990s, common wisdom told us that we were training too many specialists. Perhaps this was true for many specialties, but it was never validated for the pulmonary and critical care physicians. Medical schools tried to cut the number of fellows trained in all specialties, including ours. I must apologize for picking on the state of Florida in this discussion, but I live there, was involved in all the matters that occurred, and have little knowledge of affairs in other states. Not only did the medical schools cut the numbers of fellows trained, but the American Lung Association (ALA) suddenly prevented the Florida Lung Association (or any other state associations) from funding clinical fellows. I was distressed by this decision because in 1979, the division heads from the three medical schools in Florida initiated the Pulmonary Wintercourse sponsored by the Florida Thoracic Society and the Flor-ida Lung Association. The single purpose for founding this course was to raise money to fund the training of clinical fellows. This goal was accomplished , and the Florida Lung Association funded the training of one fellow in each of the three institutions for 18 years. Since 1997, however, funding has been restricted by the ALA to research, including money generated by the Wintercourse. I was one of the three division heads that started the course. I felt betrayed in 1997 when the money could not be used for the purpose that we originally intended. …