Special article: increasing the number of generalist physicians--a new regulatory paradigm

Increasing the number of generalist physicians has become a major component of health system reform proposals. This change in physician manpower may be attempted by educational approaches, market-driven responses, or regulatory requirements. Regulatory approaches may be considered in the broad contexts of public policy models. Two such models considered in this essay include 1) the acceptance of health care as a positive claim right that places the responsibility for providing health care on the state, and 2) a shift in the role of government in general from reacting to public concerns to activity shaping them. Each results in a greater governmental, regulatory intervention on medical manpower planning. As these policy constructs gain or lose force or favor, so too will their impact on medical education.