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David A. Kindig, MD, PhD

JAMA. 1994;271(19):1505-1507.

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

THERE HAS recently been renewed interest in the specialty balance in the US physician workforce, with many groups calling for increased production of generalist physicians. A number of factors are responsible for this, including declining medical student interest in generalist careers,¹ continued shortages in rural and inner-city areas,^2,3 increased demand from managed care organizations, cross-national experience,⁴ as well as some evidence of cost savings from higher proportions of generalists.^5,6 The Council on Graduate Medical Education⁷ has called for a reduction in first-year graduate medical education positions to 110% of US medical graduates with a 50:50 generalist-to-specialist mix, and the Physician Payment Review Commission⁸ has also considered such changes. Similar recommendations have been proposed in the Clinton Health Security Act as well as independently in Congress. Such changes are significant and could be approached from a variety of educational, financial, and regulatory perspectives.

In order . . . [Full Text PDF of this Article]

Author Affiliations
From the Programs in Health Management and Department of Preventive Medicine, University of Wisconsin—Madison Medical School.

Footnotes
Reprint requests to Programs in Health Management, University of Wisconsin—Madison Medical School, Second Floor Bradley Memorial, 1300 University Ave, Madison, WI 53706-1532 (Dr Kindig).

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