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Background: Research on the international recruitment of health professionals to the U.S. has focused almost exclusively on physicians and nurses; we are aware of no research on the migration of allied health professionals., Objective: We examined the strengths and weaknesses of various public and private data sources on foreign-educated allied health professions in the U.S. and patched together a picture of these migrants. We focus on pharmacists, physical therapists (PTs), occupational therapists (OTs), speech language pathologists (SLPs), and medical and clinical laboratory technicians (lab techs)., Findings: Based on the American Community Survey, we found that 12% of PTs, 12% of lab techs, 8% of pharmacists, 4% of OTs, and 3% of SLPs are foreign-born and entered the U.S. at age 21 or older. Among foreign-born PTs, about half remain as non-citizens, suggesting the highest proportion of recent arrivals among the five professions., Conclusions: As Congress debates comprehensive immigration reform, one of the much need changes to the system is better immigration data, disaggregated by occupation.

The Institute of Medicine's report "Retooling for an Aging America: Building the Health Care Workforce" concluded that the US health care workforce will require significant overhaul to care for the estimated 70 million adults 65 years and older by 2030. No profession trains the numbers of geriatric specialists needed to maintain the current provider to patient ratio. Pharmacy is no exception; currently less than 1% of pharmacists are certified or have specialty training in geriatrics. Schools of pharmacy, accrediting and professional organizations, and boards of pharmacy will need to collaborate to ensure that pharmacists have the core competencies to care for older adults.

Experienced nurses and other allied health workers will be in gravely short supply in the very near future--every board must make it a priority to address this looming crisis.

For 2 decades, health planners have forecasted impending physician surpluses, and policy decisions related to medical schools and residency programs have been based on such expectations. However, these much-heralded surpluses never materialized, and a growing body of data and opinion now point in the other direction. The question at the forefront is whether the United States is instead headed for a physician shortage. What is the evidence? This paper reviews the trends that link economic growth to health care spending and to the demand for physicians. It assesses the current environment by examining trends in the characteristics of clinical practice, signals from the medical market, and recent experiences of physician shortages in other English-speaking countries; it also discusses why past forecasting approaches may have failed. Taken together, this body of information indicates that physician shortages are emerging and that they will probably worsen over the next 2 decades. By 2020 or 2025, the deficit could be as great as 200,000 physicians--20% of the needed workforce. If remedies are to be found, the nature of the problem must be appreciated, and a consensus to solve it must be reached.

These collective initiatives will lead to additional community wide efforts as we move into the next century, for it is through these efforts that we will continue to enhance the care our patients receive. APNs, continued professional development and recruitment of health care professionals into nephrology will be pivotal to meet the evolving needs of this patient population. Nursing will play an increasingly integral role in influencing the health care arena as all disciplines must work together in our changing environment.

In summary, it is evident that there is a great need for the collection of much more definitive data. I believe these data are essential to those in decision making positions and ASAHP would be an appropriate organization to collect and disseminate these data. I would urge you all, when you receive a survey from ASAHP asking for manpower related data, to be certain that the survey is completed, is accurate, and is returned. We will try to insure that the instructions are clear and precise. Perhaps we need to make our data collections state specific. We certainly need to include information regarding the level of managed care in each institution's area so that we can begin to examine the effects of managed care on the placement of our graduates. I also believe it is important to identify trends in employment because this makes possible rational decisions about program size and discontinuation and also insure the provision of programs that will benefit our graduates and the communities we serve. Although data from this survey were not presented in this article, the author would like to express her profound gratitude to Ms. Soon Merz, Director of Institutional Research and Planning and Ms. Amy Rhoads, Associate Director of Institutional Research and Planning at Kansas University Medical Center for their considerable work in analyzing and summarizing the data.

ASAHP recommends that the federal government should, as the largest consumer of health care, play a central role in partnership with state governments and private institutions in reducing shortages of allied health personnel. Furthermore, ASAHP believes that this role should encompass attracting students (particularly from minority and underserved portions of the population) both to academic allied health programs through the provision of entry-level traineeships and advanced programs which prepare allied health professionals for careers as educators and researchers. No federal programs were authorized specifically to support allied health education during the period from 1981 to 1989. PL 100-607, the Health Professions Reauthorization Act of 1988, authorized $6 million ($2 million in each of three categories), but only $737,000 was appropriated in FY 1990 for Allied Health Grants and Contracts. The Bureau of Health Professions subsequently received 122 proposals in February 1990, representing more than $10,000,000 in requests for this limited amount. Since then, the Bureau has received an average of 100 proposals for each annual funding cycle. In addition to providing continuation grants for existing projects, the Bureau is currently able to award an average of 10 new grants each year. The $3,935,000 appropriated for FY 1995 will be used to fund perhaps another 12 to 15 initiatives. ASAHP believes that substantially more financial assistance is required than what is currently being appropriated. Furthermore, the most suitable venue for the federal government to affect reductions in the shortage of allied health professionals is through the advanced training portion of the Section 766 Program, which remains unfunded.(ABSTRACT TRUNCATED AT 250 WORDS)

Upon learning that 95% of all fatal traffic accidents occur within three miles of one's home, an acquaintance moved to another residence four miles away and is still alive today. The world might be a much better place if most obstacles could be overcome this handily. Unfortunately, the problem of allied health personnel shortages appears to be more intractable. Because the situation is complicated in nature, it is most unlikely that any single remedy will suffice. Public and private interests have joined forces in many states, but it is abundantly clear that conventional market forces are unlikely to prevail. These forces usually focus on supply and demand. While shortages may cause entry-level salaries to rise, they do not stimulate academic institutions to increase their output nor will they affect the availability of research funding and/or doctoral training programs. Current market forces compel health facilities to engage in bidding wars for scarce manpower. Although individual job seekers may benefit, this practice does not increase the number of training program graduates. The federal government has a decisive role to play in assuring an adequate number of personnel to meet this nation's health care needs. Assistance is necessary in the form of providing entry- and advanced-level traineeships to accelerate the flow of part-time students pursuing doctorates, and to fund model student recruitment/retention projects. This role should encompass attracting students (particularly from minority and underserved portions of the population) to academic programs. The Disadvantaged Minority Health Improvement Act, PL 101-527 that was enacted in November 1990, contains only minimal provisions for allied health. Eligibility for student scholarship assistance is restricted to a small handful of allied health professions. Moreover, allied health is not eligible for the loan repayment program aimed at individuals who agree to serve on the faculty of health professions schools that historically train individuals from disadvantaged backgrounds. It is difficult to envision how serious underrepresentation of minorities in allied health will be affected by this legislation. Clearly, special consideration by the federal government is required to produce a cadre of allied health caregivers drawn from the ranks of those whom they serve. Allied health research is needed to expand the basis for practice, increase knowledge, and generate studies pertaining to the efficacy of practice. Funding is required to support the development of scholars and scholarship in allied health institutions to ensure a pool of qualified faculty members. Finally, many difficulties result from a lack of governmental visibility.(ABSTRACT TRUNCATED AT 400 WORDS)

This article reviews, in retrospect, the Registered Care Technologist proposal previously advanced by the American Medical Association. It argues that an analysis of this proposal is a useful way of understanding interest group theory. Further, it makes a case for nurses in general and Black nurses in particular to understand this theory from an economic perspective. Finally, it urges all nurses to continue to collectively utilize power.

Allied health person-power education has for the past ten years shifted significantly from the hospital to college-based degree programs. Academically strong co-sponsored (college-hospital) programs offer considerable advantage for the health professional. Radiologic technology education generally has not kept pace with this trend. The need in radiologic technology education is not for additional training programs, but for better ones, and for continuing education for in-service personnel. Radiologic technologists should challenge their local institutions of higher education to provide for their needs and aspirations.

The growth and geographical distribution of selected allied health professional groups were compared with medicine, dentistry, and nursing for the periods 1970 to 1980 using data from the US census (1970 to 1980) and AMA Physician Masterfile. GINI indexes of health professionals concentration were computed as global measures to evaluate changes in the pattern of locational choice. All allied health professional groups reflected large percentage increases ranging from 25% to 432% in supply of practitioners from 1970 to 1980, with a median percentage increase of 71.9%, and compared well with medicine and dentistry. These allied health supply increases were generally related to better distributional outcomes among the general population and physicians, although several allied health groups became less evenly distributed during this decade. These gains were realized during a decade when less federal support was available for the allied health professions compared with medicine, dentistry, and nursing.

Multiskilled practitioners have been in health care settings for a long time. The form multiskilled practitioners have taken has varied with the cultural, socioeconomic, and technological constructs of the times. Some multiskilled practitioners have come and gone while others, such as the medical assistant and physician assistant, have remained. The complexity and sophistication of skills being combined have increased over time as have the degree level and opportunities for dual certification. Skills have been combined both across and within disciplines. There is currently a greater number and variety of formal programs to prepare multiskilled health practitioners in educational institutions and health care facilities, and more informal on-the-job training efforts than ever before--and they are increasing. Employment of multiskilled personnel has become a survival strategy for health care institutions in this current era of cost containment. Multiskilled allied health practitioners with basic nursing skills (ie, LPN level) may also provide one step toward a solution to the nursing personnel shortage being experienced by some health care facilities. The catchword for multiskilled has become not "whether," but "how."15 It is to everyone's benefit to learn from the efforts of those with experience in implementing the multiskilled health practitioner concept for both national and international application. The National Multiskilled Health Practitioner Clearinghouse intends, through its publications, services, and resource files, to serve as the cornerstone upon which the information from those with experience can be reposited and disseminated.

Problems in the provision of health care to rural areas in the United States include the distribution of health workers, health care facilities, preventive services, quality of care, and economics. The problems must be clearly identified and defined if solutions are to be effective, and the cooperation of several sectors of the community is required. Community organization and political activity are often necessary to convince legislators and medical schools to assist rural communities in a solution of their major problems.

This article is the fourth in a series describing the American Occupational Therapy Association's Human Resources Project. The Project consists of several interrelated studies aimed at identifying the supply of occupational therapists and assistants in the United States as of December 1973, and at projecting requirements for their services. The present report is the second of several that will describe the results of the Member Data Survey, the objective of which is to define the geographic, demographic, educational, and employment characteristics of the AOTA membership.