In Reply.
—There can be no disagreement about whether more medical students should choose primary care, or that all students need generalist skills. But there are questions about degree and approach. I believe 50% is too many, and regulation is the wrong mechanism.
Drs Greer and Petersdorf want no quibbling with the 50% solution. At the same time, Mr Kobrinski and Dr Mansfield are attempting to better define primary care (the Institute of Medicine is doing the same), and others are examining a variety of issues relevant to the physician workforce.1-4 Continued research is badly needed—to illuminate, not obfuscate.
Medicine is entering an unprecedented era of physician abundance—an abundance of both primary care physicians and specialists. Our data indicate that a 33%-67% mix of career paths for new physicians (a significant increment in primary care over the recent experience) would create what might be termed "balanced abundance," ie, too
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