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January 29, 1973

Number of Physicians And Health Care

JAMA. 1973;223(5):560. doi:10.1001/jama.1973.03220050060033

To the Editor.—  While Drs. Senior and Smith (222:178, 1972) may have valid points when they argue against the presumed shortage of physicians in this country, some of the supporting evidence is highly questionable.In Table 2, they endeavor to show that contrary to the Carnegie Commission findings,1 the United States in 1967 had a lower infant mortality than nine selected other countries with higher physician to population ratios. They appear to give little thought to the doubtful validity of comparing such crude figures. Most postpartum deaths are due to prematurity and immaturity. Thus, infant mortality depends, to a great extent, on the accepted borderlines between "abortion" and "birth." These definitions change from state to state in this country and even more so in foreign lands.The figures are substantially influenced by the frequency of immature and premature births in various communities. Those countries that had pioneered in the