Subspecialties and Physician Maldistribution

Abstract

To the Editor. —The article by Martini 1 in JAMA contains useful information but conveys an unbalanced perspective concerning the relationship between and specialists. The article concludes by stating that the increase in the number of subspecialties has been responsible for the improper geographical distribution of physicians and has generated an improper mix of specialties, and the number of approved specialties and subspecialties is the result of proceeding without successful planning or coordination. Since 1985 there have been 60 applications for subspecialty recognition by the 24 boards of the American Board of Medical Specialties (ABMS). Only 34 applications have been approved. Standards for review and approval of subspecialties are published and accepted by the medical profession with participation from all of the member boards and the six associate members of the ABMS: the American Medical Association, the Association of American Medical Colleges, the Council of Medical Specialty Societies, the