Benchmarking the future generalist workforce.

CONTEXT Previous workforce analyses by the Council on Graduate Medical Education (COGME) have concluded that the United States has too few, or just enough, generalists. However, recent trends suggest that more physicians are entering primary care, raising the possibility of a future surplus. OBJECTIVE To project the future supply of generalists relative to future requirements. DESIGN We developed a model that projects the supply of generalists into the future on the basis of the annual number of physicians entering and leaving the workforce. We calculated the number of clinically active generalists from the physician master-files of the American Medical Association and American Osteopathic Association. The number of graduating trainees entering the generalist workforce was calculated from the 1999 to 2000 AMA Annual Survey of GME. The number leaving was calculated by using age- and sex-specific rates or physician death and retirement provided by the Bureau of Health Professions. MEASUREMENTS Projected per capita number of clinically active generalists to the year 2025, relative to physician requirements suggested by COGME and several regional benchmarks of physician supply. RESULTS The supply of generalists is projected to grow from its current level of 69 per 100,000 to nearly 88 per 100,000 by the year 2025. Adjusting for the changing age-sex structure of the physician workforce decreases the "effective" supply to 85 generalists per 100,000. By the year 2025, the effective supply of generalists will exceed COGME's upper estimate of generalist requirements (80 per 100,000), resulting in an excess of about 18,000 full-time equivalent generalists. The future supply of generalists will also exceed most current regional benchmarks of generalist supply. CONCLUSION At current levels of training, the supply of generalists will grow substantially and soon exceed several benchmarks for generalist requirements.