As anxiety about the high cost of medical care turns its searchlight around the profession, surgery inevitably takes its turn in the spot. Is the main problem of medical manpower as related to surgery too few doctors, as has been assumed for years by planners, or is it maldistribution? Significant rumblings have been heard in recent years to suggest the latter.1-3 A recent summary by Masson et al4 working in the Sloane School of Management at the Massachusetts Institute of Technology has brought this point of view into focus. They have made some cogent points.
Decrease in Generalists.—The figures for concentrations of doctors available for primary care in the United States are as follows:
In the Tri-State Regional Program Area of Massachusetts, Rhode Island, and New Hampshire only 20% of the 2,451 general practitioners are under 50 years