To the Editor.
—While it is gratifying to read that someone from Johns Hopkins acknowledges family medicine and general internal medicine in one sentence, the recommendations made by Dr Johns1 for health care reform exhibit a naivete about primary care that seems to characterize overspecialized institutions such as Johns Hopkins.
Johns recommends a dual track in which "the path of the young physician would divide into those pursuing generalist training and those pursuing specialist training. For the first group, the internship year would be followed immediately by 2 years of advanced generalist residency training.... [M]edical school graduates pursuing specialist training... would go directly into 2 years of national health service...."
Johns here establishes a false Cartesian duality that maintains that primary care medicine is not a specialty and suggests that primary care can be adequately provided by internship-level "warm bodies" awaiting "specialty" training.
From my own experience as a
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