For many years, we have recognized that a geographic maldistribution of physicians exists in this country. Although many more physicians are being trained now than before the enrollment changes of the 1970s, there are now communities with no physician at all, which, in earlier years, enjoyed the availability of a loyal practitioner who worked until his death or incapacity. Fortunately, the maldistribution factor is being included in discussions of access to care. However, the provision of insurance coverage for individuals in many parts of this country will not ensure them the provision of a physician.
In recent months, I have often been confronted by the medical needs of small communities-either by those with no medical care, or by those that needed much more than was available. Business and industry leaders in such areas point out the potential economic impact of health care facilities in their counties. Overworked and relatively isolated physicians may accuse the state's medica