Prologue: Regardless of what one thinks about the absolute number of physicians needed in the future, there is a clear consensus among experts that something should be done to increase the proportion of primary care physicians in relationship to the number of specialty physicians. In this essay, Steven Schroeder, a professor of medicine and chief of the Division of General Internal Medicine at the University of California, San Francisco, makes the case for increasing the number of generalist physicians. Schroeder says there are four basic reasons why decreasing the relative supply of specialists makes sense: to increase the quality of care; to decrease the cost of care; to increase patient satisfaction; and to increase physician satisfaction. He brings to the subject of health manpower impeccable credentials as the driving force behind a highly successful department of general internal medicine that operates in an environment that places a premium on specialty care. Schroeder, educated at Stanford and Har...