The Journal of the American Board of Family Practice, Vol 12, Issue 3 206-213, Copyright © 1999 by American Board of Family Practice

ARTICLES

What do family physicians believe and value in their work?

G. W. Saba
Department of Family and Community Medicine, University of California, San Francisco, USA.

BACKGROUND: Family practice has always valued physician self-awareness. Whereas self-awareness has traditionally focused on problem relationships with patients, generally unexplored are the physicians' personal beliefs and values that strongly influence their routine clinical work and collegial relationships. Thus we know little about the nature and scope of these beliefs and values. The following study was undertaken to foster a better understanding of beliefs and values that residents bring to their clinical practice. METHODS: Applying 13 years of experience with one method of structured reflection and conversation, I was able to perform a cross-set analysis of findings from interactions with 143 family practice residents. Such dimensions as views of life and death, role of physician, and process of healing served as avenues to elicit beliefs and values. RESULTS: The residents' responses yielded the following six themes: philosophy and spirituality, the nature of suffering, the strains of helping, the healing relationship, the coherence of models, and clashes with the models of patients and colleagues. CONCLUSION: These conversations with family physicians-in-training suggest that they bring to their clinical and collaborative relationships complex, highly personal models of medicine that emphasize meaning and human relationship and serve as a source of strength. To better understand these models, future work should investigate the general beliefs and values of experienced family physicians in various practice settings, how their models of medicine interact and perhaps clash with those of their patients and colleagues, and effective methods for helping family physicians articulate their views so they can function effectively in their clinical practice.

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