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INTRODUCTION

A health care system is only as good as the people working in it. The most valuable resource in health care is not the latest technology or the most state-of-the-art facility, but the health care professionals and other workers who are the human resources of the health care system.

In this chapter, we discuss the nation’s three largest health professions—nurses, physicians, and pharmacists, as well as physician assistants (PAs) and social workers (Table 7–1). What are the educational pathways and licensing processes that produce the nation’s practicing physicians, nurses (including nurse practitioners), pharmacists, PAs, and social workers? How many of these health care professionals are working in the United States, and where do they practice? Do we have the right number? Too many? Too few? How would we know if we had too many or too few? Are more women becoming physicians? Are more men becoming nurses? Is the growing racial and ethnic diversity of the nation’s population mirrored in the racial and ethnic composition of the health professions? To answer these questions, we begin by providing an overview of each of these professions, describing the overall supply and educational pathways. We then discuss several cross-cutting issues pertinent to all these professions.

Table 7–1Number of active practitioners in selected health professions in the United States, 2016–2017

PHYSICIANS

As a fourth year medical student preparing to apply for residency training, Susan Unshur needed to make a decision about her choice of a specialty. She had particularly enjoyed her medical school experiences in pediatrics, and was fascinated by the elective she took in pediatric surgery. But training in pediatric surgery would require at least 6 years of residency and fellowship, and once she completed training, she would face long work hours including being on call for emergency cases. She could complete a pediatrics residency in 3 years to become a general pediatrician, but that was one of the lowest paying specialties and Susan worried about being able to pay off the $175,000 in educational debt she had accumulated in medical school. Dermatology, emergency medicine, and ophthalmology residencies required only one more year of training relative to pediatrics, and those specialties paid very well and allowed for a more controllable lifestyle. The good news was that no matter what specialty Susan chose, there seemed to be plenty of practice opportunities in the region.

Approximately 960,000 physicians are professionally active in the United States (National Center for ...

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