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November 7, 1986

Hybridization of the Primary Care Disciplines

Author Affiliations

Lansing, Mich

JAMA. 1986;256(17):2345. doi:10.1001/jama.1986.03380170061016

To the Editor.—  While combining the strengths of family practice and internal medicine training might result in a more well-rounded physician, I doubt that the primary care physician envisioned by Christiansen et al1 and Dr Geyman2 can or should exist. First, the proliferation of medical information makes it impossible to train and then maintain this physician who strives to be all things to all people. The detractors of family practice label those physicians "jack of all trades, master of none." Four years hardly seems adequate time to become even remotely familiar with the "non-internal medicine" disciplines mentioned by both authors.Second, the current liability climate argues against a generic primary care physician. I noted with some annoyance that both authors mentioned obstetrics almost in passing. This is an area of enormous liability, yet it receives insufficient attention in most medical schools and family practice residencies. Obstetricians are increasingly