For market-based reform of the healthcare system to succeed, a thorough restructuring of the nation's 10.5 million practitioner work force is needed to deliver more cost-effective medical care. But that's easier said than done.
So we welcome a recent report of the Pew Health Professional Commission's task force on healthcare work-force regulation. The effort follows by just a few weeks an earlier Pew report that suggested drastic reductions in the number of physicians, nurses and pharmacists.
The two studies together offer thoughtful ideas on the role of workers in a fundamentally transformed healthcare system built around integrated financing and delivery networks. Development of such organizations requires access to data on clinical effectiveness across sprawling medical-care organizations and places more emphasis on primary care, prevention and team work among caregivers.
But the upheavals under way also accentuate turf battles and inflexibility among groups of professionals, and throw a spotlight on unnecessarily high costs caused by duplication and failure to coordinate activities. Such developments are counterproductive and out of step with today's requirements.
Not every recommendation in the Pew reports is achievable-or even prudent. Slashing the number of incoming medical school students by 25%, for example, may be an overreaction. But changes are necessary and will need broad support to overcome many obstacles in a field where training of health professionals is steeped in tradition and grounded in conservative medical practice. Organized nursing already has taken a hard-line stand on its future role, making an objective outside view paramount for the industry's future.
High on the industry's agenda should be increasing cross-training of personnel and expanding the roles of trained professionals to allow the lowest-cost, most competent professionals to perform needed duties. Such actions are imperative to improving public access and making America's healthcare work force more effective.