Starting salaries for the two principal primary care specialties whose members often act as "gatekeepers" have risen significantly as managed care has grown in recent years, reports the physician recruitment company Weatherby Health Care. But new family physicians command higher salaries than new internists in some states, while in others it's the reverse. The company's recent surveys make possible a state-by-state matchup of the two specialties' median starting salaries that is unpredictable but startlingly even. Internists "win" in 24 states, versus 22 states plus the District of Columbia for family physicians. However, factoring in state populations by treating the two specialties as if they were presidential candidates vying for electoral votes produces a different result: a 294-to-224 "victory" for family practice. (Alaska and Hawaii were excluded from the surveys because a sufficient sample size was not available there; in Connecticut and New Mexico, median starting salaries for the two specialties were the same.)