Almost 15 years ago we reached a national consensus that equitable access to medical care was an appropriate social goal toward which to strive. Medicare and Medicaid were enacted to help the elderly and the poor, and these public programs dramatically increased the demand for outpatient services, particularly primary care. The national commitment to pay for these services led to a debate that centered upon three issues: Did we have adequate numbers of health care providers? Was the specialty mix of physicians appropriate to the needs of the country? Were health providers equitably distributed geographically?
Between 1965 and 1970, three