And who shall be the gatekeeper? The role of the primary physician in the health care delivery system.

In a speech at the Duke University Medical Center, the author discussed the growing interest in a primary care "gatekeeper" to monitor and/or control patient use of hospital and specialist services. She pointed out that there have been advocates for such a system for over 50 years-partly to assure appropriate levels of care to the entire population, partly to reduce the costs of more expensive specialist care. She went on to discuss the issues inherent in such a concept.