Physicians and Nurses

As inputs into the production of health

Introduction

Understanding the Physicians Market

• The Requirements for Becoming a Physician– Graduation from accredited school.– MD Doctors of medicine.– Other medical practitioners limited by licensing

Licensing

• CNA (Certified Nursing Assistant) 150 hrs of training• LPN (Licensed Practical Nurse) 9months-3 years• RN (Registered Nurse) exam after one of 3 routes

(Assoc., BA, Hospital)• NP (Nurse Practitioner) RN plus advanced training• PA (Physician Assistants) 2-3 years post BA• MD (Doctor of Medicine) 4 years post BA plus 1 yr

intern min. plus residency.• DO (Doctor of Osteopathic Medicine) 4 years post BA

plus 1 yr intern min. plus residency.

Post WW II Shortage of physicians

• Health planners evaluation of the physician supply

• Economic analysis of the “physician shortage” • Barriers to entry • Policy response to shortage

Choice of field specialization

• Using economic incentives to alter the distribution of physicians

• Public policy change incentives • Incentives provided by the private insurance

market • Has changing the incentives made a difference?

• http://www.cejkasearch.com/compensation/amga_physician_compensation_survey.htm

National average 29% Female

Supply of Physician Services

• Backward bending supply curve for physicians

– Income versus substitution effect of rising wages.

• Gender Effects. Women Supply fewer lifetime hours to market.

Projections about the supply and demand of physicians:

• Views of economists and health planners

MD

DO

• In the United States, there are two types of physicians that practice medicine. Most physicians hold the Doctor of Medicine degree (M.D.), while osteopathic physicians hold the Doctor of Osteopathic Medicine degree (D.O.).[1] Other than teaching manual medicine, the medical training for an M.D. and D.O. is virtually indistinguishable. D.O. physicians complete conventional residencies in hospitals and training programs, are licensed in all states, and have rights and responsibilities, such as military service, that are identical to M.D. physicians and surgeons.[2]

In 2002, there were 125 medical schools in the United States. As of late March 2012, the Liaison Committee on Medical Education (LCME) had granted full, provisional, or preliminary accreditation status to 12 new medical schools, bringing the total number of U.S. medical schools to 137.2

Understanding the Nurses’ Market

Has there been a chronic shortage of Nurses?

• Historical overview: 1980 to the Present• Cyclical shortages and policy responses • Nurses wages • Is the market for nurses a monopsony

US Ave=836

Monopsony

• http://highered.mcgraw-hill.com/sites/007297883x/student_view0/chapter16/interactive_graph_2.html

• http://glencoe.com/sites/common_assets/advanced_placement/mcconnell_18e/interactive_graphs/26_2/auth.html

Projections about future demand and supply for nurses

Gender and RNs

• Men still comprise a very small percentage of the total RN population although their numbers have continued to grow. Of the estimated 2,694,540 RNs in the US, 146,902 or 5.4 percent are men. This is a 226 percent increase in the number of male RNs in two decades. In 1980, the number of men in the RN population was estimated at 45,060 or 2.7 percent of the RN population. Each of the surveys indicates that the number of men has grown at a much faster rate than has the total RN population.

PA s per 100,000