Questions 1-11 are based on the following passage.
This passage is adapted from Atul Grover, “ Should Hospital
Residency Programs Be Expanded to Increase the Number of
Doctors? ”20 13 Dow Jones & Company.
Thanks to baby boomers, the population over 65 will
have doubled between 2000 and 2030. And when the
Affordable Care Act takes full effect, up to 32 million new
patients will seek access to medical care, many of whom will
5 need treatment for ailments that have gone undiagnosed for
years, such as cancer, diabetes, arthritis and heart disease.
This surge in demand means the U.S. will have a shortfall of
at least 90,000 doctors by the end of the decade, according to
the Association of American Medical Colleges Center for
10 Workforce Studies. Many parts of the country have too few
A small, vocal minority of researchers suggest we don't
need more doctors. That minority clearly is having an
impact: many clinicians and policy makers say there is 20%
15 to 30% "waste" in our health-care system. Elliott Fisher, a
Dartmouth professor, says those numbers are backed up by
The Dartmouth studies base their conclusions about
waste on comparisons of health-care spending in different
20 geographic areas. But other studies have shown that
differences in the health status of patients in the different
regions explain the majority of variations in spending. In
other words, urban areas, with their high concentrations of
poor people, tend to have a higher disease burden and thus
25 higher medical needs. Sicker patients, along with high labor
costs, explain the higher levels of spending found in these
urban areas —not too many doctors.
There is no question that delivery of care needs to be
better organized, and that some current reforms are likely to
30 improve patient outcomes. That's true, for example, with
experiments in team-based care. However, these
improvements in patient care have not translated to any
reduction in the need for physician time.