Seeking a Balanced Physician Workforce for the 21st Century

THE HALLS of academia and the chambers of Congress echo with a call for more primary care physicians. Much of this stems from the need that managed care systems have for more primary care providers.1-4In addition, many believe that more primary care physicians would improve access to care in rural towns and inner cities.5-7There also is a perception that we have too many specialists and that the care they provide is too expensive,3,8-14and there is alarm that the proportion of physicians training in primary care is decreasing.4,7-9,14-20 A consensus has developed that better balance in the proportion of primary care physicians and specialists must be achieved, and this consensus has been translated into a specific proposal: that the percentage of medical graduates entering the primary care disciplines of family medicine, general internal medicine, and general pediatrics be increased from the recent levels of