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December 15, 1993

Solving the Shortage of Primary Care Physicians-Reply

JAMA. 1993;270(23):2810. doi:10.1001/jama.1993.03510230046030

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In Reply.  —Drastic problems require the consideration of drastic solutions; if not sooner, more drastic later. Our imbalance of generalists and specialists has been developing for a long time. The new marketplace will correct it. The move back is just beginning nationally but is already advanced in some American locales. Our oversupply of many specialists and subspecialists will become apparent to nearly all in the very near future. Competent primary care physicians will be in great demand. What will happen to the physicians in the oversupplied specialties? The "best" ones will remain as specialists and subspecialists; the quick and lucky others will get first in line to retrain to become competent in and practice primary care in the new systems. The slow and the resisters will try to move geographically, buying some time. Early retirement or joblessness will then result for the unfortunate. Resistance will be extreme. Many specialists will