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Harold I. Goldberg, MD
Harborview Medical Center Seattle

David I. Cohen, MD
Mount Sinai School of Medicine New York

Charles O. Hershey, MD
Erie County Medical Center Buffalo

JAMA. 1987;258(5):614.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

In Reply.—

We concur with Dr Afable's comments and support his efforts to place ambulatory training on firmer financial ground. We neglected to discuss finances because the cost implications of our reorganization were the specific subject of a previous article.¹

We also agree with the observation by Taylor et al that academic group practices are not new, as indicated by our inclusion of six references to such organizations dating back to 1974. What was innovative about our own experience with group practice was our ability to evaluate clinic operation with the most rigorous of research designs. We believe that health services interventions should be held to the same standards of proof of effectiveness that are applied to proposed changes in clinical practice. Now that supportive data are at hand, we hope that other academic clinics will be persuaded to join family practice centers and general internal medicine programs in . . . [Full Text PDF of this Article]

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