May 6, 1998

Primary Care and the Specialist

Author Affiliations

From the Department of Health Systems Management, Tulane University Medical Center, New Orleans, La.

JAMA. 1998;279(17):1394-1395. doi:10.1001/jama.279.17.1394

For more than 30 years, there has been concern about inadequate primary care capacity in the US health care delivery system.13 Several governmental and private sector reports have noted that the generalist physician to population ratio in the United States falls below that of most industrialized countries, and that, as contrasted with Canada and the United Kingdom, where generalists constitute approximately half of the physician workforce, only about one third of US physicians fall into this category.4,5 These concerns have been heightened by the growth of managed care, which emphasizes the role of the generalist, and have led to recommendations that 50% of all US physicians and residency positions should be in the primary care disciplines.2,3

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