Problems and Promises: The Potential Impact of Graduate Medical Education Reform

The history of attempts to match the supply of physicians to the needs of health care in the United States—whether by regulation or by market forces—has not been marked by success. This gives me a cautious feeling as I read the essay by Fitzhugh Mullan and colleagues (1994), despite the fact that I share the belief with many others that it is necessary to actively increase the supply of generalists. James Thurber summed up the problem in a fable. He tells of a “fairly intelligent” fly who wisely refused to land on a spider web because there were no other flies on it, lighting instead on a piece of fly-paper crowded with flies because he assumed they were dancing. His moral: “There’s no safety in numbers, or anything else” (Thurber 1939).

Author(s): Eric J. Cassell

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Volume 72, Issue 4 (pages 713–717)
Published in 1994