The Generalist Role of Specialty Physicians

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Abstract
THERE HAVE been persistent concerns that the predominance of specialty physicians in the United States reduces access for vulnerable populations and increases the total cost of medical care.1-5 In response, a wide variety of programs have been initiated to increase the production of generalists,6 but not without controversy.7-9 Many specialists argue that they can discharge the responsibilities usually associated with primary care physicians—in particular the provision of accessible, continuous, coordinated, and comprehensive care.10 This model has been called the hidden system of primary care.11,12