Predictions of imminent large physician surpluses stem from two observ
ations: rapid increases in the proportion of Americans in managed care
plans, and the relatively lean physician staffing ratios reported for
health maintenance organizations (HMOs). We use internal data from tw
o large, mature staff-model HMOs to determine precise specialty-specif
ic physician staffing ratios, to see whether these HMOs use fewer phys
icians than the fee-for-service sector uses. The two HMOs provided the
equivalent of 180 physicians per 100,000 enrollees, which is near the
national average and far above figures that typically are reported in
the literature. Thus, caution regarding current workforce predictions
is warranted.