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December 13, 1995

The Independent Practice Association-Reply

Author Affiliations

Oakland, Calif

JAMA. 1995;274(22):1761. doi:10.1001/jama.1995.03530220027022

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In Reply.  —Drs DeWolf and Stanten are justly proud of the unique achievements of HPMG. To restate the key thesis of my article: the IPA model, as exemplified by HPMG, could be a savior of many of the current virtues of US medicine. If organizations like HPMG were to sprout nationwide, I would applaud.Responding first to their more minor points: One, I said that some IPAs have tried to institute exclusivity and that it is always a major threat. Two, both competing IPAs have widely spread networks, I apologize for simplifying the point. Three, I think that DeWolf and Stanten would agree that, in general, HPMG has held the line on reimbursement. More important, HPMG has recently instituted more profound reform (called for by my article) by forming specialty-specific committees to review care processes, a crucial move. Also, they misunderstand my point that the millennia-old tradition of medical ethics

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