This article provides the dialogue of a discussion between prominent family physicians from two generations. One, from the first generation of family physicians, was a founder of the specialty who provides insights into the origins of the specialty, its goals and aspirations, and possible future directions. The other, from a younger generation, has been a leader in managed care and its effects on family medicine; this physician discusses future changes in the health care systems and reflects on whether or not family practice will be able to adapt to those changes.