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December 15, 1993

Mandatory National Health Service

JAMA. 1993;270(23):2807-2808. doi:10.1001/jama.1993.03510230043024

To the Editor.  —I am concerned by the Editorial by Dr Johns1 supporting mandatory national health service by young physicians.Johns proposes financial incentives for attracting physicians into primary health care in underserved populations. As a student planning this career, I find his suggested incentives enticing. But mandatory service is a mistake. It kills incentive and interest. The practice of medicine has little leeway for the bored or uninterested physician. Enforced altruism is a dangerous oxymoron. It is a euphemism for bureaucratic control, the antithesis of "society's primary measures of what makes a physician special: competence, compassion, and dedication to improving the health of humanity."1To quote the famous mythical physician, Benjamin "Hawkeye" Pierce, when asked how a person so irresponsible, careless, and immature as himself managed to make it into "this man's army," he responded, "I was drafted."