Can the right mix of generalists and specialists produce the needed fix? For good drinks, getting the mix right is surely critical; not so for the physician specialty mix in health policy, because, as Miriam J. Laugesen argues, this is only one factor among many others typically advanced by critics of our health care system. Here I summarize Laugesen's argument, provide some reactions about primary care, and conclude with the usual call for more research to improve policy.

Laugesen delivers an effective critique to those who subscribe to the conventional wisdom that other countries have a better mix of generalists and specialists. Her most important contribution is to refine the policy issue beyond the content of physician specialty training to the broader functions of primary care (Starfield 1994: 1129): “First-contact, continuous, comprehensive, and coordinated care.” Laugesen's cross-national analysis of physician workforce...

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