Center for California Health Workforce Studies
Five
Professional Areas of Study
The following is
a list of the supply, requirements, market and policy issues being addressed
within each of the disciplines.
Medicine,
Nursing, Allied Health,
Dentistry and Public
Health
Medicine
California's physicians are maldistributed by specialty, geographic
location, and race/ethnicity. Medical education programs are overproducing
specialists and underproducing African-American, Latino, and Native
American physicians. Managed care is altering physicians' career choices
and financial incentives. State and federal policies have not fully
succeeded in alleviating physician shortages in underserved areas.
CCHWS is conducting the following projects in relation to these issues.
- A longitudinal study of primary care physicians to evaluate effects
of managed care on primary care physicians and to evaluate the effects
of transition to managed care Medi-Cal on physicians caring for Medi-Cal
patients.
- A survey of specialists to evaluate effects of managed care on specialist
physicians.
- A comparison of various databases on graduate medical education
in California to enhance understanding of trends in the number and
specialty distribution of medical residents.
- A review of methodologies used to assess the effectiveness of Title
VII grants in increasing the number of primary care physicians in
medically underserved communities.
- A report on federal, state, and private programs aimed at increasing
access to physician services in underserved communities with recommendations
for strengthening California programs.
- A report on the impact of the repeal of affirmative action policies
on trends in the participation of underrepresented minorities in medical
education in California.
- A report on service-contingent scholarship and loan repayment programs
for primary care physicians and other health professionals
- A report on the migration patterns of Californians pursuing careers
in medicine to assess whether Californians who complete medical school
and/or residency in California are more likely to practice in the
state and to determine whether these patterns differ across time and
among racial/ethnic groups.
- A report on trends in the participation of underrepresented minorities
in medical education in California.
- A report on recruitment and retention of primary care practitioners
in rural areas.
For facts on California physicians click
here.
Nursing
Although California's overall supply of nurses is adequate at present,
shortages remain in rural areas and some specialty areas. California's
RN supply is not keeping pace with the state's population growth. RN
recruitment difficulties are especially pronounced for specialized positions
in inpatient settings. The following projects are underway:
- A survey partnership with OSHPD to enumerate certified nurse midwives
(CNMs), nurse practitioners (NPs), and Physician Assistants (PAs).
We will compare their contributions to care for underserved populations
with those of pirmary care physicians.
- An analysis of various sources of secondary data on California registered
nurses to assess the appropriateness of increasing funding for nursing
education at public colleges and universities.
- An assessment of what commonly used measures of registered nurse
shortage actually measure and how they should be interpreted.
- An analysis of characteristics of hospitals with chronic shortages
of registered nurses.
- An assessment of the relationship between racial/ethnic differences
in educational attainment and the lack of racial/ethnic diversity
in the RN workforce.
- A comparison of CNMS, NPs, PAs and Primary Care physicians with
regards to the furnishing of care to vulnerable populations and practice
in primary care shortage areas.
- An analysis of the appropriateness of increasing funding for nursing
education at public colleges and universities.
- A synthesis of the research literature and existing data on nurse
staffing ratios.
For facts on California's nurses,
click here.
Allied Health
CCHWS is measuring supply and demand for allied health professionals
in California. Much of this work has been done in conjunction with a
grant the Center for the Health Professions has received from the California
Health Care Foundation to study this topic. CCHWS is also participating
in the National Allied Health Data Collaborative, which seeks to improve
educators' and state policymakers' access to allied health data. A report
was released in July 1999 that summarizes available data on supply and
characteristics of allied health professionals in California, describes
changes in the organization and financing of healthcare that are affecting
demand for these professionals and offers recommendations for leaders
in industry, labor and education.
Dentistry
CCHWS is conducting a systematic evaluation of the supply of dentists
in California. Studies of access to dental care suggest that shortages
of dental personnel pose a major barrier to access to care in inner-city
and rural areas. CCHWS has three publications available relating to
dental shortage areas.
- A report that ranks
and maps medical services study areas (state-designated rational service
areas) in California by ratio of dentists to population to identify
communities with greatest need for dental personnel.
- A journal article
summarizing our analysis of the characteristics of community with
greatest need for dental personnel.
- A working paper
on California dentists' participation in Medicaid.
As well, CCHWS is pursuing three new projects related to the distribution
of dental services.
- A pilot project examining the validity
of current Dental Health Professional Shortage Criteria.
- A collaborative Project with the Arizona Office of Oral Health examining
the availability of dental services across Arizona
- A project examining the recruitment
and retention of oral health care practitioners in underserved areas
of California.
For facts on California's Dentists,
click here.
Public Health
California lacks a comprehensive source of detailed information on its
public health workforce and the impact of market and public policy forces
on that workforce. CCHWS is undertaking three public health projects:
- A project examining the demand for
and utilization of professionals (MDs, RNs, DDSs and MPHs) in local
and state public health departments in California.
- A report on the characteristics of local health departments in California.
- A survey of public health nursing in five California counties to
explore the changing roles of public health nurses in local public
health departments.
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