FORUM ON THE STATE OF THE HEALTH WORKFORCE It’s Time to Address the Problem of Physician Shortages Graduate Medical Education is the Key

It is now widely accepted that the United States is on thecusp of deepening shortages of physicians.1,2 This article will briefly review how these shortages could have been anticipated, how they are being manifested, and how policy-makers were drawn to the contrary conclusion, and it will discuss the challenges that now exist as the nation undertakes to expand undergraduate and graduate medical education in an attempt to meet the projected future demand. SETTING THE STAGE FOR FUTURE SHORTAGES Anticipating the Demand for Physicians As physicians, it is natural to think about the future demand for physicians in terms of needs, such as the aging population and the obesity epidemic, or new technologies, such as implantable defibrillators and targeted therapeutics. During the 1990s, many thought that payment systems would drive the need for more primary care physicians. But none o