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To the Editor.
—Dr. Romano suggests that the desire to be located near one's training center may be a major factor in determining the location of health personnel. I am sure that he is right. By our reference to "free market mechanisms," Dr. Hayes and I did not mean to imply that economic considerations are the sole considerations in determining location. Quite the reverse is obviously true: specialists tend to aggregate in metropolitan areas where the incomes of most are smaller than they would be in less metropolitan areas. The usual deciding factors are symphonies, schools, football teams, and so many others that, as we said before, the factors are beyond analysis unless the analysis includes extensive study from numerous disciplines. And since the study would involve subjective and even subconscious motivations, we frankly despair that analysis could be accurate or even worth the effort.The alternative to free market
Randall HG. Geographic Distribution of Ophthalmologists and Optometrists. Arch Ophthalmol. 1975;93(6):465. doi:10.1001/archopht.1975.01010020479014