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March 20, 1987

Health Care in the Year 2000

Author Affiliations

North Carolina Memorial Hospital Chapel Hill

North Carolina Memorial Hospital Chapel Hill

JAMA. 1987;257(11):1472. doi:10.1001/jama.1987.03390110048014

To the Editor.—  Dr Goldsmith's Special Communication entitled "The US Health Care System in the Year 2000"1 encompasses many issues important to the future of the medical profession. Although one can always disagree with what another sees in a crystal ball, articles such as this greatly benefit us by forcing us to think about and examine the consequences of the many changes occurring in medicine today.One important issue that Dr Goldsmith raises is best exemplified by the cartoon showing "Frank's Neurosurgery" (Fig 2). As the author states, we will find more and more "substantially underemployed" specialty physicians as the number of physicians continues to rise. Unfortunately, underemployed specialists sometimes look to primary care as a way to keep patients and income—"Frank's Neurosurgery" becomes "Frank's Neurosurgery and General Practice." Despite a relative lack of attention from medical schools and medical centers, the appropriate treatment of the diseases that make