Review and Update of the 1995 Physical
Medicine and Rehabilitation Workforce Study
Overall Effect
on Demand
The panel was asked to summarize its overall assessment
of demand, excluding managed care, using the physician to population ratio as
a measure of the demand that can be supported by the market. (The effect of
managed care is estimated separately by the model, given baseline demand,
managed care growth, and an "elasticity.") The actual physiatrist to
population ratios for the 50 largest metropolitan statistical areas for the
years 1994 and 1996, along with HMO penetration rates, were presented to the
panel
(Figure 7). In addition, the panel was presented
with the actual 1996 aggregate ratio for urban and for rural areas, along with
the demand ratios represented by the "current information" case and
the "full information" case in the 1995study (Table
8).
The panel was asked for its assessment of the demand
ratio over several time intervals. Its median responses are listed in Table
9. The demand, adjusted for managed care growth and "smoothed"
between years, is shown in Figure 8. The panel’s
revised demand estimate is compared to the new supply estimate in the figure.
The revised demand and supply curves suggest that the
amount of physiatric services demanded will approximately equal the number of
physiatrists available to provide those services—at an unchanged
price—through the period 1996-2017. Although supply will almost double over
that period, demand will keep pace, primarily because managed care growth is
projected to be slower, and the effects on demand smaller, and because efforts
to inform the market about the advantages of PM&R services will continue
to succeed.
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