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July 30, 1973

The Carrot or the Stick

JAMA. 1973;225(5):518-519. doi:10.1001/jama.1973.03220320048016

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For many years past, the number of specialists trained in any particular field has been determined by accident or by the appeal of the specialty. To a certain extent, it has been the carrot at the end of the stick that has induced medical students to select a certain future field of endeavor.

Sometimes the carrot has taken the form of a dollar sign, sometimes leisure time, sometimes prestige in diagnosis or treatment. Never has the selection been due to adequate guidance or by an attempt by organized medicine to provide an equitable balance in the product of our educational process. The needs of the sick people of this country have been completely ignored.

Who should be responsible for creating a proper balance of specialists to care for the needs of our people? The federal government has told the farmer how many acres of corn or wheat or beans that