RT Journal
A1 Goodman DC
T1 HEalth workforce planning and medical student career choice—reply
JF JAMA
JO JAMA
YR 2009
FD February 25
VO 301
IS 8
SP 824
OP 826
DO 10.1001/jama.2009.160
UL http://dx.doi.org/10.1001/jama.2009.160
AB 
In Reply: Drs Rabkin and Cook argue that medical workforce planning is bound to fail without medical financing reform that addresses the perverse incentives of fee-for-service reimbursement. I agree. The evidence is also robust that a greater infusion of public dollars to expand graduate medical education is likely to lead to more fragmented care and higher costs without improvements in access, quality, and outcomes.1- 3 Less widely discussed, the additional physician capacity will adversely affect the pace and direction of health care reform. It is hard to imagine a more efficient and coordinated health care delivery system evolving during an era when teaching hospitals greatly expand the training of subspecialists.