To the Editor.—In the article by Dr Halm
and colleagues,1 the authors made several
assumptions that may not be true. For example, they stated that physicians
with fewer years in practice were more accepting of gatekeeping because they
have "less entrenched expectations about a traditional, fee-for-service medical
marketplace" than their more seasoned colleagues. But physicians who have
been in practice for a longer time may simply feel a greater attachment to
their patients and as a result were more sensitive to some of the gatekeeping
rules such as those that regulate the use of consultations.
Volpintesta E. Gatekeeping: Good or Bad, but Never Indifferent. JAMA. 1998;279(12):908–910. doi:10-1001/pubs.JAMA-ISSN-0098-7484-279-12-jbk0325
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