I found Dalen's1 article on US physician manpower needs in the January 8, 1996, issue of the Archives to be extremely informative. In addressing the issues relative to generalists and specialists and medical care in rural and other underserved areas, Dalen makes many valid observations. He also points out the complexity of the issues relative to the proper balance of service activities in training programs and the overall impact of international graduates on health care in the United States.
One particular area that he discussed is extremely important to the provision of health care in this country and that is the question of access. Somehow we have lost sight of the fact that there are approximately 38 million people in the United States who do not have health care insurance. It should also be kept in mind that the uninsured or underinsured population continues to increase with a downsizing of