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January 22, 1982

Reimbursement of Physicians

JAMA. 1982;247(4):462. doi:10.1001/jama.1982.03320290012011

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To the Editor.—  In a recent COMMENTARY (1981;246:1203) entitled "Reimbursement Problems Encountered by Private Physicians," Frances Siegel, MD, complained about the disparity between fee schedules of primary care specialists (ie, pediatricians, obstetrician-gynecologists, internists) and family practitioners. She argued that it was inequitable for one to receive a higher payment for the "same service," since both graduated from programs of equal length. The inference that family practitioners and primary care specialists have had equal training is patently false. Family practitioners spend a brief portion of their training in each of the specialities and while in practice their efforts toward continuing medical education must be diffused over the entire spectrum of primary care, not to mention surgery. The fact is that family practitioners simply do not offer the "same service" to their patients. I agree with Dr Siegel that family physicians, as a general rule, do offer excellent medical care; however, it