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December 15, 1993

Mandatory National Health Service

Author Affiliations

Oklahoma City, Okla

JAMA. 1993;270(23):2806. doi:10.1001/jama.1993.03510230043017

To the Editor.  —I believe Dr Johns1 is wrong that there is a need for a higher percentage of physicians as generalists. There is no good evidence that a physician pool composed of a higher percentage of generalists will be more efficient or cost-effective than the current mix of specialists and generalists. Johns' idea of changing this mix by giving a financial incentive to those who pursue generalist training is the same old idea of socialistic central control and planning that has so often been shown to be inefficient and the ultimate undoing of socialism. Those making such recommendations generally feel that they themselves know what is best for others, and if they could direct people into the proper specialty, they could achieve the proper mix. Our free enterprise medical system has produced the best medical care in the world and it works best without meddling or central control.