During the 1990s, health care restructuring in Nova Scotia resulted in downsized hospitals, reduced inpatient length of stay, capped physician incomes and restricted practice locations.
In Nova Scotia, substantial health system restructuring occurred during the study years and initially capped physician incomes, restricted practice locations, downsized hospitals, provided new hospital-in-the-home capacity, initiated redevelopment of a provincial home care program and introduced drug co-payments for seniors receiving government drug benefits.
[W]e find no evidence that the adoption of damage caps increased physician supply in nine new-cap states, relative to twenty no-cap states... Consistent with this analysis, we also find no association between med mal claim rates and physician supply in state and county fixed effects regressions over 1995-2011... Physupply supply does not seem elastic to med mal risk.
So, if the relationships between both damage caps and healthcare costs, and damage caps and physician supply, are tenuous — what, if anything, do we know for sure?
"That includes education, prevention, naloxone for overdose reversal, and expanding access to treatment with buprenorphine by raising the cap for physicians and permanently allowing trained nurse practitioners and physicians assistants to prescribe buprenorphine".
Many respected researchers have probed the relationship between damage caps and physician supply.
Regarding therapy, both family and ER physicians followed recommended Canadian guidelines for empiric therapy of CAP, with family physicians prescribing newer macrolides and emergency department physicians prescribing respiratory fluoroquinolones [ 15].
The HHS increase in the physician cap to 275 will increase access as well, but these measures will not close the treatment gap.
Of those, some have found no evidence that damage caps measurably increase physician supply.
Although a higher percentage of ER physicians than family physicians reported CAP to be very important (58% vs 49% respectively) this difference was not statistically significant (p = 0.56).
The shortages are putting pressure on medical schools to boost enrollment, and on lawmakers to lift a cap on funding for physician training and to ease limits on immigration of foreign physicians, who already constitute 25% of the white-coated workforce.
