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Deborah Cotton, MD, MPH
Beth Israel Hospital Harvard Medical School Boston

JAMA. 1989;261(4):556.

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In Reply. —

Drs Clark and Ginsberg appropriately call me to task for failing to mention family physicians as likely people to provide primary AIDS care. Indeed, many of the skills needed in caring for patients with AIDS are ones used daily by such practitioners.

However, in contrast to Dr Dolan, I am not optimistic that family practice, any more than general internal medicine, offers a totally appropriate model for primary care of patients throughout the spectrum of HIV infection. Thus, I still believe that with time, a separate AIDS specialty may well evolve. Such a specialty ideally would incorporate many of the attributes of family practice mentioned by Dr Dolan as well as draw on knowledge of the medical subspecialties, public health, epidemiology, law, and ethics.

Finally, I agree with Dr Zelicoff that among the many barriers to physician recruitment in AIDS, deficiencies of reimbursement to physicians providing such . . . [Full Text PDF of this Article]

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