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January 15, 2003

Challenges Facing Family Practice and Primary CareChallenges Facing Family Practice and Primary Care

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;289(3):297-300. doi:10.1001/jama.289.3.297-a

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.