Assertions that the Australian working medical workforce supply is low are common. This study identified a lack of home-based acute care as underlying an over-sized hospital system in Australia, a system that is generating excess medical workforce. It proposes that the challenge for Australia is to shift acute medical care into the community and downsize hospitals.

Key findings

• Counted in the same way as do all other OECD countries (including doctors working but not yet fully registered as per OECD guidelines), Australia’s supply per 1,000 of the population is nearly the highest in the OECD.
• With retirement factored in, supply is well ahead of population expansion, itself nearly the highest within the OECD.
• The high medical workforce supply derives from an over-expanded public hospital sector with a high rate of acute overnight ‘curative’ hospitalisation. It stems from inadequate provision of community-based acute care. 
• Excess supply of medical workforce can decrease the quality of healthcare. There are strong arguments in favour of measures to improve the management of acute medical illness by providing community-based acute medical care.