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September 1, 1989

Physician Need

Author Affiliations

St Joseph Hospital Denver, Colo

St Joseph Hospital Denver, Colo

JAMA. 1989;262(9):1184. doi:10.1001/jama.1989.03430090046019

To the Editor. —  I read with interest your article1 on physician need in the April 7 issue. I assume that part of the authors' conclusions was that prepaid health plans might offer a different (maybe more cost-effective) view of future physician need. I must point out one flaw in the secondary assumption that past physician need in health maintenance organizations (HMOs) predicts future HMO need. The authors stated that "the HMOs we studied used more primary care and internal medicine specialists" and "family physicians were used by the plans studied in proportion to their availability at the time, but at a rate substantially below the GMENAC [Graduate Medical Education National Advisory Committee] projected need for family physicians (5.2 vs 13.2 family physicians per 100 000)."Does this mean that these HMOs will always want family physicians in this proportion? Our experience in Denver with one of the HMOs