WASHINGTON -- The United States is rebounding from a doctor shortage in the 1960s, and a federal advisory committee predicts a surplus of 77,000 physicians in 1990.
The Graduate Medical Education National Advisory Committee called for a 17 percent cut in medical school enrollment and sharp restrictions on the entry of foreign-trained doctors in an attempt to achieve a balance between doctor supply and the people's requirements in the mid-1990s.
The report, presented Tuesday to the Department of Health and Human Services, said there were 44,000 too few doctors in the nation in 1978 and a slight shortage still exists today.
But the panel said expansion of medical school classes started to offset the shortages in the 1960s, along with the influx of thousands of doctors trained abroad, soon will produce too many physicians in most fields.
Dr. Alvin R. Tarlov, chairmen of medicine at the University of Chicago and committee chairman, said he believes a doctor surplus would increase national health costs because studies have shown that as doctor densities rise in a particular area, physician use rates also increase.
However, he said some would argue that the increased competition among large numbers of doctors would tend to drive down prices, increase availability and provide better geographic distribution.
By 1990, the committee predicted there would be 536,000 doctors with a requirement for 466,000. Even if the figure is too high by a third or half, the panel report said, there still will be a surplus because of the long time required to reduce the doctor supply.
The committee predicted there will be surpluses in 1990 in 15 specialized fields. It forecast a surplus of 11,800 general surgeons and a surplus of 10,450 doctors specializing in obstetrics-gynecology.
But the panel forecast a doctor shortage in child psychiatry, emergency medicine, preventive medicine and general psychiatry. It said the need for psychiatrists for children will be particularly acute with only 4,100 in 1990 while 9,000 will be needed.
The committee said there should be just be enough doctors in family and general practice, general internal medicine, pediatrics, hematology, dermatology, gastroenterology and otolaryngology.
