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December 15, 1993

Solving the Shortage of Primary Care Physicians

Author Affiliations

Roanoke, Va

JAMA. 1993;270(23):2809-2810. doi:10.1001/jama.1993.03510230046029

To the Editor.  —Dr Johns'1 recent proposal for mandatory national medical service for all US graduates and Drs Lundberg and Lamm's2 subsequent support should not go unanswered. Not only is this an extreme example of the kind of social tinkering that encourages distortion of our profession, it will not work.A mandatory national medical service at best may provide transiently improved access in underserved areas. However, Johns offers no evidence that such a mandatory system would be better or cheaper than our current National Health Service Corps.Staffing these sites with new graduates who have only internship training is a step backward. In the increasingly complex world of primary care, proposing that geographically or socially isolated practice sites be manned by intern graduates, especially ones who have their eyes narrowly on specialty training, is begging for substandard care and physician dissatisfaction. Retention at service sites is already low.