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November 1989

Comprehensive Primary Health Care

Author Affiliations

716 Northcrest Dr Salt Lake City, UT 84103

Arch Intern Med. 1989;149(11):2404-2406. doi:10.1001/archinte.1989.00390110010003

I n my last letter, I indicated that I would write to you again concerning the questions you raised about the type of health care program that I provided for all office patients.

In regard to whether there are enough physicians to provide comprehensive primary health care, I have always felt, speaking in purely economic terms, that medical care is a commodity that is bought and sold in the marketplace. When the demand is present, the supply will become available. Actually, the predominant request today is for symptomatic care rather than comprehensive primary care. Training two types of physicians, one to provide symptomatic care and the other to provide comprehensive care, has been suggested. I agree with the statement by George Engel, MD, Professor of Medicine and Psychiatry, Medical School, Rochester, NY, in the reprint that I sent you: "It is better to have two categories of health professionals, one

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