Section 1

  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

  doctors already.

  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

  Dartmouth research.

  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.