Addressing Health Workforce Maldistribution: A Medical Service Proposal

Abstract

Purpose: To review the literature on medical service schemes internationally and empirically evaluate their success in achieving more equitable health workforce distribution. Furthermore this paper seeks to use this information to frame a proposal for medical service in the US context. Methods: A comprehensive database search was used to identify major studies providing data on comprehensive medical service schemes and their success in various countries. This information was used to evaluate what kinds of medical service schemes work and what kind of policy proposal would have merit in the United States. Results: Based on data from over seventy countries spanning different income levels and human resource availability medical service schemes successfully redistribute physicians to areas they are needed. These policies furthermore seem to improve the health outcomes of local populations. Conclusions: A medical service scheme requiring resident physicians in the United States to provide two years of primary care service in underserved areas has the potentially to effectively increase access to healthcare and improve health outcomes in these areas.