To the Editor.
—Dr Cooper1 presents a broad overview of the conditions and context of the physician workforce environment into the next century. He succinctly describes the forces that prevail in the determination of the mix of generalists and specialists from the current system of education and training. His recognition of the impact of current proposals on specialty training programs, identification of the distribution deficiencies that are a system problem rather than a workforce problem, and acknowledgment of the future contribution of primary care by midlevel practitioners are especially noteworthy and illuminate key deficiencies in the current incentives that work against establishing an effective balance of the primary care workforce. Unless their focus and their impact can be more clearly specified, however, we disagree with the implication of his conclusion that the balancing of regulatory and market forces alone will achieve a balanced workforce. We believe that a better
Kobrinski EJ, Mansfield CJ. What Is Balance in the Physician Workforce?. JAMA. 1995;273(12):915-916. doi:10.1001/jama.1995.03520360029020