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December 23, 1992

Why Washington University Doesn't Need/Can't Afford Family Practice-Reply

JAMA. 1992;268(24):3431-3432. doi:10.1001/jama.1992.03490240039022

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In Reply.  —The October 9,1991, issue of JAMA was devoted to the centennial of the Washington University School of Medicine. I appreciated the invitation from JAMA to include an Editorial in which I reviewed the successes of our institution.Dr Paul M. Fischer responded to the Editorial, criticizing the absence of a department of family practice at Washington University. I elected not to reply to Fischer's letter because it did not seem to call for a response, and because the Editorial that concerned Fischer was not meant to be a position paper on the hard choices the school's leadership have made over the years. Now comes Dr Dell who suggests that I should not "be reasonably excused from that responsibility" (responding to "reasonable, thoughtful, bona fide letters") even though JAMA does not mandate responses.In order to defray the issue of responsibility, let me answer Fischer's letter. Above all, let