To the Editor.
—In contrast to federal and state generalist initiatives that view physician requirements in terms of numbers of trainees in various specialties (typically calling for a goal of training 50% in primary care), Dr Kindig's1 recent article questions the use of specialty counts, concluding the following:The current assumption that every physician head count in a primary self-designated specialty is equivalent in any terms, particularly in terms of meeting patient care requirements, is unacceptably crude for workforce planning for the 21st century.If the current approach of utilizing counts of physicians who self-designate in generalist specialties is indeed "unacceptably crude" for workforce planning, rectifying it requires that we revisit the issue of a hidden system of primary care provided by specialists. McDermott2 raised this issue in the early 1970s at a time of rapid expansion in the nation's medical education capacity. Aiken et al3 later
Radecki S. Workforce Planning: Estimating Emergency Physicians and Uncovering Primary Care. JAMA. 1994;272(24):1899-1900. doi:10.1001/jama.1994.03520240027030