To the Editor Ms Gudbranson and colleagues offered a provocative reexamination of the adequacy of the US primary care physician workforce.¹ We have several concerns regarding their analysis.

They estimated demand for primary care using the total number of US primary care visits per year. This is not a measure of demand but another way of measuring supply; that is, the number of appointment slots available to patients. To our knowledge, there is no available measure of the more pertinent value: the number of visits sought. How many patients, when faced with a 20-day wait time, forgo care or make a costly emergency department or urgent care visit? This is particularly pertinent in rural areas, where clinicians may be lacking.

Gudbranson女士及其同事向美国编辑提出了对美国初级保健医师劳动力充足性的挑衅性重新审查。¹我们对他们的分析存在一些担忧。

他们使用每年美国初级保健就诊的总数来估算对初级保健的需求。这不是衡量需求的方法，而是衡量供应量的另一种方法。即，可供患者使用的预约空位数量。据我们所知，尚无可衡量的更为相关的价值：所寻求的访问次数。面对20天的等待时间，有多少患者放弃护理或进行昂贵的急诊或急诊就诊？这在可能缺乏临床医生的农村地区尤为重要。