Medical Informatics Applications

Policy for Physician Supply Change:
false impressions, retirement crisis, and migration -
as seen through systems analysis and a mathematical model

Table of Contents

Health Care Policy: Managing Physician Supply on a State Level

Problem #1: Too Few Active Primary Care Physicians

Physician Surveys Show Disappearing Physicians

Patient Load per a Primary Care Physician in Virginia

Discrepancy between Licensed and Active Physicians

Problem #2: After 2005 We May Be Faced with the Retirement Crisis

The Crisis and New Medical Schools Graduates

Problem #3a: The Amelioration of the "Physician Supply River"

Problem #3a: The Amelioration of the "Physician Supply River"

Since 1995 the Patient Load May Have Started to Increase

Problem #3c: The Importance of In-State Medical Schools

Definitions of Accretion and Attrition of Workforce

Physician Supply Change by Professional Origin - 1

Physician Supply Change by Professional Origin - 2

Components of Attrition and Accretion

The Structural Diagram of Physician Supply Model

RWJ Foundation Physician Supply Model

Definition of Model Variables

The Balance Equations to Identify the Model Parameters

Block Diagram of the Model. Time Introduced

The Stable Age Distribution of Physicians since the Old Time

The Age Distribution of Physicians in Our Time of Dynamic Changes

A Plausible Dynamics of the Components of Physician Supply

The Age Distribution of Physicians in Our Time Achieved in the Model

Dynamics of Active Physicians and Patient Load till 1995

Accretion and Attrition of Physicians Fitting the Observed Supply and Load Dynamics

The Patient Load Will Start to Increase after 2005

A Scenario for Positive Change in Future

The Target Patient Load Achieved

An Example of the Residency Program Graduates In-State Retention

Slowing down Net Increase of Primary Care Physicians

Switching from Increase to Steady Decrease in Migration Turn-over

Qualitative Dynamics of Physician Supply

Qualitative Dynamics of Physician Supply: Optimal Solution and Delays

Email: volchans@vcu.edu

Medical Informatics Home Page:
"http://www.medinf.vcu.edu"

Other information:
Dr. Olchanski's Personal Home page:
"http://www.mipt.vcu.edu/volc.html"

The results have been reported in conferences:

V. Olchanski, R.B. Williams. Primary care physicians supply in Virginia: Preliminary analysis with a dynamic simulation model. 23rd Annual Meeting of the North American Primary Care Research Group (NAPCRG), Houston, November 1995.
V. Olchanski. Modeling Physician Supply at the State Level. Modeling Health Professions Supply and Needs: A Workshop for State Planners. Sponsored by the Bureau of Health Professions, HRSA, and Cecil Shepps Center for Health Services Research, Chapel Hill, NC, November 1997.

And published in journals:

V. Olchanski, D. Marsland, L. Rossiter, R. Johnson. Behind the Physician Licensure Numbers: False Impressions, Retirement Crisis, and Migration. Clinical Performance and Quality Health Care, No. 6, 1998 p.142-146.
V. Olchanski, D. Marsland, R. Johnson, L. Rossiter. Primary Care Physician Supply Policy Analysis on the State Level. Clinical Performance and Quality Health Care, No. 6, 1998, p.129-137.

See a short description of the project.

The Course of Medical Informatics
in Medical College of Virginia
Virginia Commonwealth University

VCU Department of Internal Medicine