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Need-based requirements for primary care physicians.

THE SHORTAGE of primary care physicians resulting from a maldistribution of physicians among the specialties is considered one of the major problems in today's health care system. What constitutes "an adequate supply" of primary care providers has not been defined. The proportion in 1975 was 38% of the total physician supply.1The stated goal of the American Medical Association and the recommendations of the Institute of Medicine is 50% of the total physician supply. The rationale for this goal is difficult to determine and appears to be conjectural, based on opinion and on physician specialty distributions in other countries and in health maintenance organizations (HMOs). The literature abounds with primary care requirements studies, with estimates ranging far below and far above this stated goal.2 I examined primary care physician requirements from a "need" perspective. The concept of need is defined by Lee and Jones in their 1933 study