To the Editor.—I will not be the only reader to see a connection between the reports of Earp and others1 and Napodano and others2 in your February issue. Although more than one interpretation can be made from Earp's data, it is reasonable to conclude that the internal medicine subspecialty fellows they interviewed did not have ideal attitudes for primary care.
When I read that only three of 34 respondents (9%) felt that they should be responsible for their patient's psychosocial problems and that only nine (27%) would like their patients to call them personally for medical advice when needed after hours, I can only hope that few of these fellows will later find themselves with primary responsibility for a patient's care. But I know, as documented in the references accompanying the article by Earp et al, that this will not be the case.
The kind of training