In Reply. —Drs Kaplan, Stern, and Espenschade raise a very important issue, the appropriate utilization of part-time or volunteer clinical faculty who are in private practice as clinical role models. I did not address this in my commentary because my primary focus was the effectiveness of geographical full-time faculty as clinician teachers. The negative impact of the academic reward system on the quality of clinical teaching and on patient care was also a central concern. Clearly, the potential for part-time clinical faculty to serve as effective role models warrants careful consideration. However, there are some major stumbling blocks.
One potential problem is the limited availability of private practitioners who are willing to serve as inpatient and/or outpatient attendings on a regular basis. Over the course of the past three decades, the full-time faculty of many teaching centers has grown, while the formerly very active and influential part-time clinical faculty group