"Decisions about the physician supply should be made on the basis of evidence for their utility in improving health and reducing ill health and deaths. Currently, the United States has many more specialists than do other comparable countries with better health levels," said Barbara Starfield, MD, MPH, lead author of the study and a University Distinguished Service Professor in the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health.
The study authors reviewed mortality data from 1996-2000 for 3,075 U.S. counties, which make up 99.9 percent of all U.S. counties. The researchers found that having a higher specialist-to-population ratio did not decrease mortality rates. They also determined that too many specialists would negatively impact communities because more patients would be seen by specialists and would be more likely to receive unnecessary tests and procedures.
The researchers report that, in the United States, the boundaries between the roles of specialists and
primary-care physicians are blurred. In countries other than the U.S., specialists typically work in hospitals and see patients only on referral from primary-care physicians, so that the roles are clearly delineated. In the U.S., however, specialists may treat patients for ailments outside their area of expertise, thus putting patients at a higher risk of death. In additio
Contact: Kenna Lowe
Johns Hopkins University Bloomberg School of Public Health