It's the whipsaw effect.
Cause 1:
A 1970s report by the Carnegie Commission on Higher Education, Higher Education and the Nation's Health, showed a national shortage of physicians and dentists. It recommended "expansion in health professions education, warned against overspecialization, supported training of physician and dentist assistants, and proposed creation of a national health service cops."
Effect 1:
By 1971, The Comprehensive Health Manpower Act "provided loan and scholarship money as well as funds for both new and expansion construction and operating costs. It provided an even more powerful incentive for growth by linking schools' eligibility for funds to increases in first-year enrollments - 10 percent for schools with 100 or fewer first-year students and 5 percent for larger institutions. Funding for dental schools increased from $64 million in 1970-1971 to $80 million in 1971-1972 but dropped back to $57.8 million in 1974-1975. Between 1971 and 1975, six new dental schools were established.
Cause 2:
In 1976, six years after the 1970 Carnegie report, another report by the Carnegie Council on Policy Studies in Higher Education wrote, "warned that too many medical schools were being established and that the increased supply of physicians was not eliminating geographic disparities. The report suggested, however, that enrollments in some dental schools should be expanded and that new schools were needed in Arizona and probably in Florida [Today, there are two dental schools in Arizona and three in Florida]."
Effect 2:
"Congress reacted to the changing view of health care supply question (particularly the view that there was a "physician glut") by reducing direct support for health professions education, including dental schools."
"The whipsaw effect of adopting and then removing a significant stimulus for enrollment growth had disruptive effects on both educators and practitioners that still persist in debates about the size, distribution, and composition of the dental work force and the appropriate number and size of dental schools...six schools have closed since 1985, and the overall enrollment drop is equivalent to closing 20 average-sized schools."
Field MJ, ed. Dental education at the crossroads: challenges and change. Committee on the Future of Dental Education, Division of Health Care Services, National Institute of Medicine. Washington, DC: National Academy Pres, 1995.
