Specialty Distribution of U.S. Physicians -- The Invisible Driver of Health Care Costs

Abstract

Never before have so many Americans been so aware of our health care system's two most glaring defects -- its inability to restrain runaway medical expenditures and its failure to provide basic health care for all citizens. Strangely neglected in the current debate over reform is any acknowledgment that a major cause of both these problems is the uniquely skewed distribution of our physician work force among specialties. Yet physicians drive the runaway engine of health care costs with their decisions about patient care, and their specialty training markedly affects those decisions. In fact, any effort to control costs or . . .