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National Health Work Force Policy
- John J. Whyte, MD, MPH; and
- Douglas P. Beall, MD
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
TO THE EDITOR:
There is no doubt that we need to alter the distribution of physicians. We appear to have an abundance of specialists and a scarcity of generalists. We are disappointed, however, that the College has chosen to support government regulation to institute a 50/50 ratio of generalists to specialists. This position is both untimely and counterproductive.
First, the 50/50 ratio is completely arbitrary and lacks any hard scientific supporting data. Even one of the strongest supporters of this ratio, the Council on Graduate Medical Education admits that “experimental data does not exist to define the proportion of generalists and specialists needed to provide optimal access to primary care services” [2]. How can one advocate such a radical redistribution on the basis of data that do not exist?
Second, we agree that planning should be done. It should be based, however, on physician-to-population ratios, regional variations, sex-based differences, and use of certain practice models. In addition, we should be using positive incentives such as loan forgiveness, role models, and financial remuneration to encourage medical students and young physicians to enter primary care.
Finally, the government intervention that the College advocates is unprecedented. As residents beginning our medical careers, we take offense at this interference. Should the government redistribute law students, making sure that enough go into criminal law, so that we have enough competent attorneys to serve as public defenders? We cannot force people who may lack the appropriate skills or interest to enter a particular practice field.
We suggest that the private sector be given more time to correct the maldistribution. Already, last year's residency match has shown an increase in the number of graduating medical students entering primary care.
“Freedom of choice” is the phrase patients use to ensure their ability to choose their physician. Let's give that same freedom to physicians and medical students.
John J. Whyte, MD, MPH
Duke University Medical Center; Durham, NC 27707
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
