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March 18, 1992

The Duty to Attend Upon the Sick-Reply

Author Affiliations

University of Pennsylvania Philadelphia
Association of American Medical Colleges Washington, DC

JAMA. 1992;267(11):1468-1469. doi:10.1001/jama.1992.03480110043025

In Reply.  —We appreciate the survey evidence reported by Imperato supporting our finding that New York City experienced a greater decline in house staff recruitment than did the four comparison low-AIDS cities or the nation during the 1980s.1 Indeed, we cited that work and considered it when we suggested that AIDS may have contributed to the trends we observed. We also agree that it is possible, as Clarke and Conley suggest, that match applicants did not distinguish between high- and low-AIDS programs but "chose to avoid the city entirely."2However, if, as Dr Imperato suggests, AIDS primarily accounted for our findings, we would not have expected to find as we did that New York City municipal hospitals alone accounted for the overall drop in matches to New York City. During the study period, both high-AIDS and low-AIDS voluntary residency programs experienced no absolute decline in number of matches