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To the Editor.—In their article (Amer J Dis Child 116:529-533 [Nov] 1968), Dr. J. J. Alpert and his co-workers indicate that by bringing a group of medical and paramedical personnel into a low-income area, the level of health care may be improved. This is hardly surprising in view of the inadequacy of the health care ordinarily received by such families. However, several questions arise about the applicability of the authors' experience to a large-scale attack on the health problems of low-income families.
The high physician/patient ratio cited (12 different physicians over a three-year period to 175 experimental families) seems impractical for the long-term care of large populations. The rapid turnover rate of these physicians is more characteristic of a physician education program than of a medical care program. Any meaningful, continuous relationship between physician and family would appear to be difficult in these circumstances. No mention is made of