In 1978 the Institute of Medicine issued "A Manpower Policy for Health Care," the report of a study of major issues bearing on the availability of an adequate number of physicians for provision of primary care and on potential strategies for an appropriate manpower policy. The report was analyzed by committees of the American College of Physicians, and they prepared a response to the Institute's recommendations that illuminates the position of the College on the fundamental principles of manpower policy. The "Commentary" that sets forth the College position is presented here. Some introductory comments and discussion provide a useful background to the "Commentary" for readers not familiar with these developments.