In the United States in 1990, the ratio of office-based primary physicians (family practitioners, general internists, and general pediatricians) to the general population was 1 to 1769. Group-model and staff-model HMOs with more than 100,000 enrollees have approximately one primary care physician per 1000 enrollees. Despite the anxiety over the low numbers of young physicians entering primary care practice in the United States, the ratio of primary care physicians to the general population is almost identical to that in the United Kingdom. The problem of physician supply in the United States may lie more in the relative distribution of generalists and specialists than in an absolute deficiency of primary care physicians. In addition, geographic maldistribution of primary care physicians persists in the United States. In the United Kingdom, explicit policies of physician allocation have eliminated undersupply to rural and inner-city areas.


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