The rest of the doctors practice in medical specialties that include obstetrics, gynecology, general surgery, and psychiatry. In the 1980s, managed care emerged and policymakers became concerned that the United States was not training enough primary care physicians. Success was in the hands of these doctors. Doctors were asked to act as gatekeepers and stick to more expensive specialty medicine. In 1986, Congress created the Council on Graduate Medical Education. Their goal was to offer recommendations on workforce policies for physicians. They have also released numerous reports predicting a shortage of doctors by the year 2000. Many people don't realize how serious this shortage problem is. This affects the care patients need on a daily basis. Without doctors, patients could not be seen for moderate or severe care. This obviously puts their lives at risk and may do more harm than good to others less seriously affected.