Primary care is widely perceived to be the backbone of a rational health services system. But is this perception correct? Some see it as an anachronism in the present medical era, denying and delaying the specialist attention to which patients are entitled. When primary care physicians act as "gatekeepers" to specialist services, what is the effect on outcomes? How many general practitioners are needed in a primary-care-oriented system? In this paper I address these and other questions. Let me begin with definitions.
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Barbara H. Starfield (1994) studied this question.
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