Mandatory National Health Service-Reply

Abstract

In Reply. —I am very happy to see such vigorous debate about this important issue. I hope it continues. In the best of times, compulsory medical training and service in underserved areas is less desirable than voluntarism—whether inspired by idealism or by a sense of personal or professional obligation. Those who object to my proposal that mandatory training and service be incorporated into graduate medical education fail to recognize that these are extraordinary times— for the medical profession and for the health and economic vitality of our nation. Voluntarism, supported by underfunded public health programs, has failed to provide adequate health care to millions of Americans, most notably those in underserved areas. An expanded NHSC will provide a critical mass of health care providers to this underserved population. As for the ability of physicians with only 1 postgraduate year of medical training to provide adequate primary care, I envision that