The future of primary care is in jeopardy, and nowhere is this more evident than in the current debate on physician workforce. Reversing its projections that the United States would be faced with a physician surplus by 2000,1,2 the Council on Graduate Medical Education in early 2005 projected a physician shortage by 2020.3 This conclusion was reached despite the council's estimate that the number of physicians per 100 000 population would actually increase 5% between 2000 and 2020. The projected shortage is supported by forecasts that the US population's demand for specialized services will increase more rapidly than the growth in physician supply.4
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