Managed Health Care

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Abstract
THE COUNCIL on Graduate Medical Education (COGME) was authorized by Congress in 1986 to provide an ongoing assessment of physician supply trends and to recommend appropriate public and private sector efforts to better match the physician workforce in composition and competencies to health care needs. The Council's Third Report, released in 1992, concluded that generalist and minority physician shortage, specialist physician surplus, and poor geographic distribution would hinder strategies to provide quality and affordable health care to all Americans.1Since then, the rapid growth of managed health care prompted COGME to examine its impact on the physician workforce and medical education. A broad spectrum of opinion was solicited from a report advisory group and from representatives from the managed care, medical education, and medical professional communities. This article summarizes the findings of COGME's Sixth Report. Further rationale and documentation are provided in the full report, in its citations, and