Trends in the specialist workforce in internal medicine in Australia, 1981-1995

Objective: To describe trends over the period 1981 to 1995 in the supply of consultant physicians in adult medicine in Australia, and to project these trends into the early part of the 21st century. Design: Analysis of workforce data collected by the Royal Australasian College of Physicians in censuses of Fellows in 1981, 1984, 1986, 1988, 1990, 1993 and 1995. Main outcome: Number of physicians and ratio of population aged 50 years and older per physician. Results: The workforce increased linearly from 1641 in 1981 to 2701 in 1995, while the population/physician ratio fell from 2180:1 to 1720:1, with a decreasing rate of decline. The ratio is projected to rise after 1996 to 1780:1 in 2016. Among the States and Territories, the higher the population/physician ratio in 1981 the greater the rate of subsequent decline. The proportion of women physicians rose linearly from 4.8% in 1981 to 10.6% in 1995. The age structure changed from a youthful triangular profile in 1981 towards a rectangular profile characteristic of an aged population. All specialty fields displayed a decreasing rate of decline in the population/physician ratio. The proportion of physicians practising in regional centres increased steadily from 9.3% in 1981 to 12.9% in 1995. Conclusions: Although the number of physicians has risen markedly since 1981 and the ratio of population aged 50 years and older per physician has fallen, trends suggest that the ratio will rise again early in the 21st century. Any deliberate attempt to limit the growth of the physician workforce might result in a deficit in the future when the demand for physicians is growing rapidly due to population ageing.