A COMPARISON OF 3 METHODS FOR ESTIMATING THE REQUIREMENTS FOR MEDICALSPECIALISTS - THE CASE OF OTOLARYNGOLOGISTS

Objective. To compare three methods of computing the national requirem ents for otolaryngologists in 1994 and 2010. Data Sources. Three large HMOs, a Delphi panel, the Bureau of Health Professions (BHPr), and pu blished sources. Study Design. Three established methods of computing requirements for otolaryngologists were compared: managed care, demand -utilization, and adjusted needs assessment. Under the managed care mo del, a published method based on reviewing staffing patterns in HMOs w as modified to estimate the number of otolaryngologists. We obtained f rom BHPr estimates of work force projections from their demand model. To estimate the adjusted needs model, we convened a Delphi panel of ot olaryngologists using the methodology developed by the Graduate Medica l Education National Advisory Committee (GMENAC). Data Collection/Extr action Methods. Not applicable. Principal Findings. Wide variation in the estimated number of otolaryngologists required occurred across the three methods. Within each model it was possible to alter the require ments for otolaryngologists significantly by changing one or more of t he key assumptions. The managed care model has a potential to obtain t he most reliable estimates because it reflects actual staffing pattern s in institutions that are attempting to use physicians efficiently Co nclusions. Estimates of work force requirements can vary considerably if one or more assumptions are changed. In order for the managed care approach to be useful for actual decision making concerning the approp riate number of otolaryngologists required, additional research on the methodology used to extrapolate the results to the general population is necessary.