Abstract
<h3>In Reply.—</h3> I share with the writer of the letter a deep disquietude about the fact that my comments are at variance with the<i>goal</i>of "equal access to quality care." But I was referring to<i>realities</i>, not to my or anybody else's preferences. Accordingly, despite the large number of physicians entering the medical system, I see little likelihood of practitioners setting up private practice in low-income areas, white or black. Hence, second-best alternatives relating to access and care should be explored. They are surely better than hiding one's head in the sand or taking refuge behind slogans, even idealistic ones.
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