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Regional Variations in Health Care Intensity and Physicians' Perceptions of Care Quality
- Brenda Sirovich, MD, MS; and
- Elliott S. Fisher, MD, MPH
- From the Department of Veterans Affairs Medical Center, White River Junction, Vermont, and Dartmouth Medical School, Hanover, New Hampshire.
IN RESPONSE:
We appreciate Dr. Peirce's ad hoc analysis of our data, showing that relatively higher concentrations of generalists in an area are associated with lower per capita Medicare spending. Before addressing the principle (with which we agree), it is necessary to make an important clarification to his finding. Although it is true that spending falls steadily as the percentage of generalists (family practitioners and general internists) …
