—We agree with Dr Hale and colleagues that obstetrician/gynecologists in practice care for many women who do not otherwise have a primary care provider. The fact that many women use them as primary care physicians does not make them, or any other physician, a broadly trained generalist. Our study did not attempt to address the content of practice or how competently primary care services are provided by different specialty groups. Instead, our analysis focused on the content of residency training.The 89% figure cited by the letter's authors was dependent on a separately published list of educational objectives1 that is not a required part of the Accreditation Council for Graduate Medical Education accreditation guidelines or its review process. Program citations for not addressing these objectives are unlikely to survive legal challenge since obstetrics and gynecology residencies can only be held to the standards of the Accreditation Council
Rivo ML, Saultz JW, Wartman SA, DeWitt TG. What Makes a Generalist Physician?-Reply. JAMA. 1994;272(20):1574–1575. doi:10.1001/jama.1994.03520200030019
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