In 2012, the House of Delegates of the Federation of State Medical Boards (FSMB) voted to approve the Minimum Data Set (MDS) for physicians. This endorsement is a very important milestone in the ongoing effort to improve health workforce data collection and analysis in the United States. State licensure boards are in a unique position to collect basic data that will increase our understanding and knowledge of the physician workforce, and inform both the public and private sectors. Having approved the MDS at the 2012 Annual FSMB Meeting, the FSMB and state licensure boards are now poised to begin implementation of the MDS. The National Center for Health Workforce Analysis (National Center), a division of the U.S. Department of Health and Human Services's Health Resources and Services Administration (HRSA), is partnering with the FSMB to pilot the MDS in 2014. We hope state boards will participate in this pilot and encourage them to do so. While many challenges lie ahead, the National Center looks forward to collaborating with the FSMB and state licensure boards on this exciting and crucial endeavor.
What is the Minimum Data Set?
A central goal of the MDS initiative is to establish national databases with consistent core data elements across the health professions covering demographic, educational, credentialing, and practice characteristics. While many health professions collect some data on individuals in the profession and some states collect data on licensed professions, these data collection efforts are uncoordinated and inconsistent across professions, states, and over time, which limits comparability. By encouraging a standard core set of questions, we hope to be able to provide state and federal policymakers, state licensure boards, health professional groups, and others with basic, comparison-friendly data on the health workforce. The National Center is working with more than a dozen health professions to implement the MDS. Improved data on physicians is critical to this effort, given their central role in the health care system.
We use the term “minimum” because we have tried to identify only the data elements that are of highest priority to inform programs and policies, and to reduce burden on those providing and collecting the information. The six to 10 questions selected for the MDS project are those that are most critical for tracking the health workforce and assessing need and gaps in service. These data will answer critical health workforce questions, including: How many physicians are in a community? What are their specialties? How many hours a week are they providing patient care?
Why do we need a Minimum Data Set?
A lack of relevant and timely data on the health workforce inhibits effective health workforce policy-making and investment decisions that could support improvements in the health care delivery system. Accurate data and timely information on the supply and distribution of the physician work-force is critical to informing workforce policies, programs, and investment decisions. Good private and public decision making for the future of the physician workforce relies upon quality data.
But is collecting workforce data consistent with the role of state licensure boards?
The primary responsibility of state licensure boards, and of the licensure process in general, is to help ensure that only qualified physicians practice medicine in their state. The ultimate goals are protecting the public and assuring quality care. Collecting workforce data and sharing it with the FSMB will allow the FSMB, states, and researchers to compare the supply across states and communities. It will help the federal government identify high need areas eligible for a variety of programs. In this way, the implementation of the MDS will help ensure an adequate supply and distribution, which is necessary for assuring access to care and is consistent with their ultimate goals.
Who would use these data?
One of the major beneficiaries of improved physician workforce data will be states. The information from the MDS will help state leaders understand their existing physician workforce: where they are practicing and the types of services they are providing. This information will help states make wise resource-allocation decisions, including investments in medical education and training and programs to assist their underserved communities. By using data from the FSMB MDS, states will be able to compare their workforce to those in other states on such factors as specialty, source of education and training, and age. Collecting these data over time will also allow states to see trends in their physician workforce, such as: how are they aging? How is the specialty mix changing? Are some communities losing or gaining physicians? Are retirement or migration patterns changing?
States are not the only beneficiaries of the MDS data. The federal government will also benefit from national physician workforce data, as it seeks to identify shortage areas and future physician work-force needs. Analyzing the MDS data across all states can provide valuable information about the national workforce and trends. The FSMB, national professional associations (including specialty associations), and researchers will all benefit by understanding the national physician workforce.
The role of state licensure boards
By collecting MDS data at the point of license application and renewal, state medical boards can greatly facilitate a more accurate understanding of the supply, distribution, and demographic composition of the physician workforce in the United States. While many states have already begun collecting some health workforce data, and switching to the FSMB-endorsed MDS may appear disruptive to these systems already in place, the consistency the FSMB MDS provides is crucial for a comprehensive understanding of the national physician workforce. Providing a standardized way to measure professional hours, for example, ensures that meaningful comparisons can be made across states. In addition, the only way to build a national database is for each of the boards to collect the same data. The FSMB MDS will provide the data necessary to better understand whether physician supply can meet the needs of a growing and aging population.
Several health professions, including physician assistants, nurses and physical and occupational therapists, have made great strides in implementing an MDS in their professions. Given the central role of the physician in our health care system, implementation of the MDS for physicians is critical. In collaboration with state boards, the FSMB is in a unique position to undertake this effort and to build a high quality national physician dataset. The HRSA National Center is pleased to partner with the FSMB on this important initiative. We urge state boards to participate in the 2014 pilot of the MDS and to work towards full implementation.
We look forward to working with the FSMB and state licensure boards in the coming years.
Editor's Note: As a part of our physician workforce edition, we offer this special report on the Minimum Data Set (MDS)—an increasingly discussed concept that would coordinate health care data collection nationally in a way that could improve our understanding and knowledge of physician workforce trends. The report begins with a commentary by Ed Salsberg and Christina Hosenfeld of the U.S. Health Resources and Services Administration's National Center for Health Workforce Analysis, and is followed by results from a survey by the FSMB to determine state medical board perceptions and practices regarding the collection of workforce data.
About the Authors
Edward Salsberg, MPA, is Director, National Center for Health Workforce Analysis, Health Resources and Services Administration, U.S. Department of Health and Human Services.
Christina Hosenfeld, MPH, is Public Health Analyst, National Center for Health Workforce Analysis, Health Resources and Services Administration, U.S. Department of Health and Human Services.