To the Editor: Dr Graham and colleagues1 conclude that "much of the vision [of family practice]
has been realized." I am afraid, however, that I cannot share their optimistic
assessment of the present state of our specialty. I graduated from medical
school in 1976 and was one of that original wave of enthusiastic students
who were interested in reviving and redefining the concept of family practice.
For more than 20 years I have tried to practice the basic tenets in which
I still believe so strongly and which came out of my medical school and residency
training. I work hard to get to know my patients well, including psychosocial
aspects as well as medical ones; take long and careful histories; order diagnostic
tests and procedures to confirm and clarify my clinical impression rather
than as a substitute for clinical acumen and careful history taking; and enjoy
doing as much medical care myself as I feel confident of, referring patients
out for consultation when I feel that I have reached the limits of my competence.
Fried RG. Challenges Facing Family Practice and Primary CareChallenges Facing Family Practice and Primary Care. JAMA. 2003;289(3):297–300. doi:10.1001/jama.289.3.297-a
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