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The Physician Work Force: Does the Marketplace Set National Policy?

Robert H. Fletcher, MD, MSc; and Gordon T. Moore, MD, MPH
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Harvard Medical School and Harvard Community Health Plan; Boston, MA 02215

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1994;121(9):712-713. doi:10.7326/0003-4819-121-9-199411010-00013
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Policymakers now believe that a larger role for generalists would help cure this country's health care ills, especially high costs, insufficient preventive care, and limited access to care. This belief stems from several sources [1]: the proportion of generalists in successful managed care plans in this country [2] and in other countries, where the health and satisfaction of the people are higher, and the costs are lower, than in the United States [3]; evidence that the cost of care for similar patients is higher when those patients are treated by specialists rather than generalists [4]; and dispassionate examination of the kinds of services needed by most of the people most of the time.

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