What we didn’t do is reform the training that goes on after medical school.That involves internships and training for one of 64 specialty fellowships, including general practice.
This can lead to inappropriate medical care, with examples in unwarranted eye, knee and back surgery, imaging, colonoscopy, and medication for depression and other conditions.
An undersupply of doctors is associated with lower rates of health-care use, whereas oversupply or mis-distribution can lead to higher rates of inappropriate care.
First, we didn’t finish the job of production; second, we’ve allowed too much medical specialisation in major cities; and third, our models of health care and the ways we pay for it are out of step with where community needs are heading.
Back in the early 2000s, the biggest issue relating to the training of Australia’s medical workforce was a shortage of doctors in regional and remote areas.
With 3.5 practising doctors for every 1,000 people in 2014 (4.4 per 1,000 in major cities) we’ve never had so many.