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February 13, 1995

Generalists' Prudence May Lead to Better Outcomes-Reply

Author Affiliations

Philadelphia, Pa

Arch Intern Med. 1995;155(3):336-337. doi:10.1001/archinte.1995.00430030134024

In reply  The interpretation of our findings offered by Wendel is undoubtedly shared by others. In our article,1 we acknowledge that we did not study the reasons why, during the first 3 years after the Food and Drug Administration granted approval, zidovudine was used at a lower rate by patients with acquired immunodeficiency syndrome (AIDS) who received most of their ambulatory care from generalist physicians and clinics compared with those who received most of their ambulatory care from specialists or AIDS specialty clinics.Wendel suggests that the rapid adoption of new technologies is not always sound, and he uses prostatic serum antigen screening for prostatic carcinoma as an example. We agree that generalists should use caution when applying an expensive screening test to a large segment of the population. With regard to our findings, Wendel hypothesized that generalists were probably being cautious and needed more substantial proof of the