I wanted to go back to Dr. Gold on the area of HHR. Possibly the biggest key to keeping the system working is to look at HHR. Looking at HHR, not just from the point of view of physicians but from the point of view of other health care practitioners, is a mix we need to look at.
I am glad that you brought this up, because currently we just look at the gross numbers and everyone says, we don't have enough doctors or we have too many doctors, we don't have enough nurses or we have too many nurses. The supply and demand piece and a long-term study of what's going to be coming up—given that it takes 10 years to even graduate from medical school, never mind go out and do work which could be another four years—you have such a long time that we need to look at two generations. We also need to look at what the current areas and subsets in medicine are and where they go. The bottom line in some subsets of medicine is that we don't have enough people in the subsets and then we have too many people in other subsets.
There's the whole area of incentives. Could you talk about how we can look at incentives to getting people to go to areas they don't want to go to? How do you look at incentives of getting people not to go? I know that the pressure is great when you start off owing $100,000 to want to go into the specialty that's going to give you as much money to pay off your debt immediately. How do we find the ability to say, “Everybody is 55 now, so 15 to 20 years from now we will need more students to go into a particular specialty”? How do you see that happening? I know the database will help. What incentives do you see? You can't force a person to do something they don't want to do. You have incentives. What are the incentives?