Physician distribution in a large health care system

by Andrew Cornell

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This paper presents both a historical perspective of physician distribution in the U.S. Army Health Services Command and a glimpse at how the Army might "rightsize" its future physician distribution in what is generally perceived will be a smaller active-duty Army Medical Department (AMEDD). It argues that the Army is increasingly operating in a more cost-effective and business-like manner. Further, the paper argues that AMEDD leadership can assume control of active-duty and civilian providers in each of its communities to better provide ready access to high-quality, cost-effective health care. The paper is designed to inform. It briefly describes how physicians were distributed in the past. The legitimate and primary missions of the AMEDD are presented, along with some tools to help health care managers design the most effective AMEDD for the future. The conclusions and recommendations are designed to spur action on necessary initiatives to optimally manage physician distribution for the future.

This report is part of the RAND Corporation Paper series. The paper was a product of the RAND Corporation from 1948 to 2003 that captured speeches, memorials, and derivative research, usually prepared on authors' own time and meant to be the scholarly or scientific contribution of individual authors to their professional fields. Papers were less formal than reports and did not require rigorous peer review.

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