We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......

Primary Care as Part of US Health Services Reform

Srinivas S. Vasireddi, MD
JAMA. 1993;270(20):2434. doi:10.1001/jama.1993.03510200038019.
Text Size: A A A
Published online

To the Editor.  —The 12-avenue approach of Starfield and Simpson1 to upgrade primary care in US health services is innovative. Maldistribution of physicians still leads to a significant shortage of primary care physicians across the United States.The role of international medical graduates (IMGs) needs to be emphasized. Their numbers are almost equivalent to the the graduate output of approximately 17 US medical schools, with as many as 58% of these IMGs in 1988 alone being non-US citizens.2 The bulk of them enter the United States on the exchange visitor's (J-1) program and receive their training at the expense of the United States for periods ranging from 3 to 5 years. They return to their home countries where they often find that their acquired expertise is inappropriate owing to lack of facilities and resources. Hence, the magnanimity of the United States and the well-intended purpose of the J-1


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.