For more than 30 years, there has been concern about inadequate primary
care capacity in the US health care delivery system.1- 3
Several governmental and private sector reports have noted that the generalist
physician to population ratio in the United States falls below that of most
industrialized countries, and that, as contrasted with Canada and the United
Kingdom, where generalists constitute approximately half of the physician
workforce, only about one third of US physicians fall into this category.4,5 These concerns have been heightened
by the growth of managed care, which emphasizes the role of the generalist,
and have led to recommendations that 50% of all US physicians and residency
positions should be in the primary care disciplines.2,3
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