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Primary Care in Transition

W. Benson Harer Jr, MD
JAMA. 1995;274(9):682-683. doi:10.1001/jama.1995.03530090012006.
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To the Editor.  —Dr Alper1 discusses his view of ways to increase access to primary care services in the United States. He decries the impact on reimbursement to primary care physicians as a result of the implementation of the Medicare resource-based relative value scale (RBRVS), but seems to suggest trading one problem for another. He also fails to recognize that there are physicians other than those in the specialties of family medicine, internal medicine, and pediatrics who also practice primary care.Obstetrician-gynecologists (OBGs), for example, not only provide primary care services for many women, they have the knowledge and skills necessary to serve as effectively as any physician, and more effectively than most, as a gatekeeper in any system that requires it.Alper's contention that primary care is underrepresented on the American Medical Association (AMA) Specialty Society Relative Value Update Committee is less than accurate. As the OBG representative


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