Family Physician Responds to the Future of Family Medicine

To the Editor: I read with interest Dr. Green's¹ commentary on the preparing the personal physician for practice initiative. It is necessary to go through the process of examining our specialty in light of the clear and increased need of most people to have a personal physician. It is also necessary to evaluate the strengths and weaknesses of our specialty in times of decreased attraction of our specialty to our brightest medical students. I believe this to be exactly the position of our mentors of the 1960s who “rescued” the field of general medicine in forming the specialty of family medicine.

As I review articles in the July–August issue of the journal, I note an apparent lack of evidence or input from those of us who spend almost all our professional time actually practicing family medicine. Evidence-based medicine and use of new computer technologies is certainly a present, needed change for my generation of family docs. Residency directors cannot truly expect to do more than train a new generation to grow with technology, with new medical evidence, and with their own observations. That training must include self-evaluation and learning by personal observation and should last a whole career!

This practicing family physician hopes that leaders of this project can devise and find support of trials of their ideas and ideals in actual practices. Enrolling experienced practitioners in serious discussions of the future of family medicine is critically necessary. Despite the struggles of practice, we do a needed and valuable service to the residents of our communities. Finding ways to give credit to our strengths while honestly seeking to correct our weaknesses—that has to be the goal of our specialty if it is to survive.