TOO MANY DOCTORS IN THE HOUSE
July 10, 2006
The most serious problems facing our health care system -- accelerating costs, poor quality of care and the rising ranks of the uninsured -- cannot be solved by adding more doctors, says David C. Goodman, a professor of pediatrics and family medicine at Dartmouth Medical School.
Many studies have demonstrated that quality of care does not rise along with the number of doctors. Compare Miami and Minneapolis, for example:
- Miami has 40 percent more doctors per capita than Minneapolis, and 50 percent more specialists, according to the Dartmouth Atlas of Health Care, a study of American health care markets.
- The elderly in Miami are subjected to more medical interventions -- more echocardiograms and mechanical ventilation in their last six months of life, for example -- than elderly patients in Minneapolis are.
- This also means more hospitalizations, more days in intensive care units, more visits to specialists and more diagnostic tests for the elderly in Miami. It certainly leads to the employment of many more doctors in Florida.
But does this expensive additional medical activity benefit patients? Apparently not, says Goodman. The elderly in places like Miami do not live longer than those in cities like Minneapolis.
- According to the Medicare Current Beneficiary Survey, residents of regions with relatively large numbers of doctors are no more satisfied with their care than the elderly who live in places with fewer doctors.
- And various studies have demonstrated that the essential quality of care in places like Miami -- for example, the treatment of colon cancer, heart attacks or any other specific ailment -- is no higher than in cities like Minneapolis.
Studies of individual hospitals have likewise shown that while the doctor-patient ratio varies widely from place to place, more doctors do not mean better care, says Goodman.
Source: David C. Goodman, "Too Many Doctors in the House," New York Times, July 10, 2006.
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