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March 3, 1993

Promoting Primary Care: Where to Start?

JAMA. 1993;269(9):1111. doi:10.1001/jama.1993.03500090047018

To the Editor.  —Stimmel's1 otherwise excellent Special Communication on primary care perpetuates the myth that the professional demands on primary physicians are inevitably more burdensome and their life-styles necessarily less desirable than those of other specialists. It is true that there is little need for night and weekend services in such limited fields as dermatology and pathology and that emergency physicians provide around-the-clock service by working in shifts. However, patients in most clinical specialties may require care at any hour of the day or night, and off-hours care is typically provided by residents, salaried hospital-based physicians, and members of physician groups taking call in rotation. These strategies are equally available to family physicians and other primary care specialists.It is also untrue that primary physicians typically work longer hours than their colleagues in other disciplines. Available data indicate that the former fall in the middle of the range of