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May 25, 1984

Access to Medical Care-Reply

Author Affiliations

Columbia University New York

JAMA. 1984;251(20):2659. doi:10.1001/jama.1984.03340440019013

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In Reply.—  I share with the writer of the letter a deep disquietude about the fact that my comments are at variance with the goal of "equal access to quality care." But I was referring to realities, not to my or anybody else's preferences. Accordingly, despite the large number of physicians entering the medical system, I see little likelihood of practitioners setting up private practice in low-income areas, white or black. Hence, second-best alternatives relating to access and care should be explored. They are surely better than hiding one's head in the sand or taking refuge behind slogans, even idealistic ones.