Estimating the Impact of State Manpower Policy: A Case Study of Reducing Medical School Enrollments

Abstract. Perceptions of an impending oversupply of physicians have prompted proposals to reduce medical school enrollments in a number of states. Most of these states are also concerned with improving the specialty and geographic distribution of their medical manpower. The present study provides estimates of the effects of reduced numbers of in-state medical school graduates upon the future supply of phy-sicians in Texas, and examines the medical school origin, medical specialty, and practice location of selected groups of Texas physicians. The results suggest that in Texas enrollment reductions would have no significant impact on physician supply over the next 15 years, and might actually prove counterproductive in altering phy-sician distribution. The analysis of Texas data illuminates the unintended conse-quences likely to accompany a policy option that has been widely embraced by state officials largely on the basis of its intuitive appeal. Medical manpower policy is one of many areas substantially affected by the recent shift of public responsibilities from federal to state and local governments. As the era of federaustate partnership in health manpower comes to a close, stat