Debating Flexner’s Net Effect and Alternatives

The U.S. has a physician shortage, created in part by a century-old reform that shut down bad medical schools. But why haven’t we filled the gap? Why are some physicians so unhappy? And which is worse: a bad doctor or no doctor at all?

• SOURCES:
  • Karen Clay, professor of economics and public policy at Carnegie Mellon University.
  • Rochelle Walensky, physician-scientist and former director of the CDC.

• RESOURCES:
  • "Medical School Closures, Market Adjustment, and Mortality in the Flexner Report Era," by Karen Clay, Grant Miller, Margarita Portnykh, and Ethan Schmick (National Bureau of Economic Research, 2025).
  • "Application Overload — A Call to Reduce the Burden of Applying to Medical School," by Rochelle Walensky and Loren Walensky (New England Journal of Medicine, 2025).
  • "Challenges to the Future of a Robust Physician Workforce in the United States," by Rochelle Walensky and Nicole McCann (New England Journal of Medicine, 2025).
  • "The first step to addressing the physician shortage," by Rochelle Walensky and Nicole McCann (STAT, 2025).
  • "Physician Workforce: Projections, 2022-2037," (National Center for Health Workforce Analysis, 2024).
  • “Projected Estimates of African American Medical Graduates of Closed Historically Black Medical Schools,” by Kendall Campbell, Irma Corral, Jhojana Infante Linares, and Dmitry Tumin (JAMA Network, 2020).
  • "Medical Education in the United States and Canada," by Abraham Flexner (The Carnegie Foundation for the Advancement of Teaching, 1910).

• EXTRAS:
  • "Is the Air Traffic Control System Broken?" series by Freakonomics Radio (2025).
  • "Are You Ready for the Elder Swell?" by Freakonomics Radio (2025).
  • "Are Private Equity Firms Plundering the U.S. Economy?" by Freakonomics Radio (2023).

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