I got this email about FP being in demand and it made me reflect, for once,
about what we have accomplished and what we stand for:
1. We continue to be in the highest level of demand for physicians in the nation.
Specialties in Demand (Listed by the AMA Marketing Service March 1, 2002): Family Practice, Internal Medicine, Orthopedics, Obstetrics-Gynecology, General Surgery, and Radiology.
In short supply: Cardiology, Emergency Medicine, Pediatric Critical Care, Nephrology, and Obstetrics-Gynecology. (Note: we also provide many of these services that are in short supply, mental health is perhaps even a greater need, but no one pays for it. Of course we do it anyway.)
2. We in Family Medicine have grown from nowhere to the largest office-based specialty in the nation. We have organized generalists and to some degree, generalism, into a discipline.
3. Our efforts with medical students have been outstanding, even if they don't always choose Family Medicine. Rotations, curricula, preceptorships, efforts throughout medical school, student health, AAFP Student Resident efforts and meeting, student interest groups, etc.
4. We are the best distributed - Policy Center work on distribution
5. We are adapting our training to fit the needs of people in this nation and other nations. Variety of training models from impoverished inner city to isolated rural and other countries overseas.
6. We are struggling. Yes, this is good news. We have not given up. Our compromises are fewer and somewhat more known than in other disciplines and are hopefully temporary. Our willingness to debate and discipline and reform is one of our most important qualities. We are working toward doing a better job, even in the face of adversity The evidence is in our literature, our list serves, our emphasis on working with diverse peoples, populations, the mentally ill, health systems, etc.
Where We Should Concentrate
1. Admissions - we need students interested in serving to be admitted in increasing numbers to medical school, whatever it takes.
2. We need to court and marry Family Medicine to underserved populations and the clinics and physicians that serve them. We should continue to tailor our training so that those interested in service and especially in serving the underserved, choose our training programs.
3. We need research demonstrating our value; comprehensive global approaches showing what can happen when we do provide our kind of care to various types of patients over time (impact not just on medical care, but on public health, meeting unmet needs in society, mental health, etc.) . We must change the system of measurement of physicians not just for our benefit, or for improving our discipline, but for our society.
We don't need rhetoric or false claims or promises or compromises. We need to continue our solid track record in the face of adversity. When faced with obstacles, see below for advice.
Robert C. Bowman, M.D.
Rbowman@unmc.edu
Built within our traditional medical systems are roadblocks. I find many of these to be irrelevant or myths. I try to spend my time getting by these to deliver the best care that I can. Robert Boyer, M.D., Kingman, KS rural physician and First AAFP Doctor of the Year
Do not expect to be applauded when you do the right thing, and do not expect to be forgiven when you err. But even your enemies will respect commitment - and a conscience at peace is worth more than a thousand tainted victories. Senator Bail Organa (Princess Leia's father in Star Wars) words by author Michael Kube-McDowell