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Wonderful article--thanks so much for the story and excellent analysis. I hope our ACGME family medicine residency review committee notes this type of analysis in an evaluation of the necessity of continuing with the 1650 continuity requirement. I believe that we can support idealism, patient-centeredness, and better satisfaction with family medicine if we drop the 1650 and concentrate on continuity in another way. Recognizing the complexity of our continuity patients, and supporting continuity across sites of care will support development of the type of family medicine colleagues that we would like to have. Our residents don't have the ability to give up clinic time to see their continuity patients in the hospital if they have a complex panel and need to get to 1650. They do not get to see real continuity because we are putting up too many barriers.