To the Editor:

The “shortage” of family physicians described in your article “Encouraging News About Family Physician Recruitment” [April 2005] got me thinking about the shortage of Rolls-Royce dealerships in my county (we don't have any). I'm sure a survey would suggest that 99.3 percent of people would want a Rolls if it were available. However, when asked what they'd be willing to pay, most would respond, “$25,000 or less.” When told the actual price of the Rolls, the demand would drop to 0.001 percent.

Busy family physicians struggling to keep their practices afloat can relate to this. Of course, in our line of work, high prices result from high overhead, which results from the mandates of third parties. Not that it matters to consumers; they just know health care is expensive. They'll wait until they have a problem they can't ignore and then go to a specialist.

I believe four things must be done to save family medicine:

• Family physicians must be trained to be competent and confident in diverse procedures currently relegated to specialists;

• We need tort reform to limit punitive damages and eliminate joint and several liability;

• We need to take an ethical stand and never contract with a third party;

• We need to facilitate and market health savings accounts.