Family Medicine: The Discipline, the Specialty, and the Physician

  • Robert B. Taylor


Family practice, celebrating its 20th anniversary as a specialty in 1989, continues to play a major role in medicine and Society. Remaining true to its origins, family medicine is the integrationist force that counters the fragmentation and coordinates the technological advances in medicine. In addition, family medicine has assumed leadership in the delivery of—as well as teaching and research in—primary health care. Emerging areas of excellence, such as geriatrics, adolescent medicine, and health promotion, and initiatives, such as the introduction of new journals, speak to the continuing vitality of the discipline. This chapter presents an overview of the origins and current status of family medicine, describes the discipline, the specialty, and the practitioner in terms of 12 core concepts, and offers some future projections in the context of current trends.


Family Medicine Family Physician Family Practice Residency Training Program Family Life Cycle 
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  1. 1.
    The Report of the Citizen’s Commission on Graduate Education. The graduate education of physicians. Chicago: American Medical Association, 1966.Google Scholar
  2. 2.
    The Report of the Ad Hoc Committee on Education for Family Practice of the Council on Medical Education. Meeting the chal-lenge of family practice. Chicago: American Medical Association, 1966.Google Scholar
  3. 3.
    Taylor RB. Family practice—the specialty that puts it all to-gether. Med Student 1984; 11 (1): 8–13.Google Scholar
  4. 4.
    Pfeiffer RJ. Early adult development in the medical Student. Mayo Clin Proc 1985; 58: 127–134.Google Scholar
  5. 5.
    Special requirements for residency training in family practice. Directory of residency training programs accredited by the Accredi-tation Council for Graduate Medical Education 1985–86. Chicago: American Medical Association, 1985, pp 21–25.Google Scholar
  6. 6.
    Notices. N Engl J Med 1986; 314: 930.CrossRefGoogle Scholar
  7. 7.
    American Academy of Family Physicians Reprint No. 155L, Kansas City: AAFP, July 23, 1986.Google Scholar
  8. 8.
    Brown DC. Family practice—what’s the difference? Can Fam Phys 1979; 25: 1484–1487.Google Scholar
  9. 9.
    Friedman CP, Slatt LM, Baker RM, Cummings SB. Identifying the content of family medicine for educational purposes: an empir-ical approach. Med Educ 1983; 58: 51–57.Google Scholar
  10. 10.
    Beasley JW, Hanson MF, Ganiere DS, et al. Ten central elements of family practice. J Fam Pract 1983; 16: 551–555.PubMedGoogle Scholar
  11. 11.
    Chao J. Evaluation of seven essential family practice concepts. Fam Pract Res J 1985; 4: 152–167.Google Scholar
  12. 12.
    Merenstein JH, Berg AO, Eidus R, et al. Training residents for the future: final draft report. (Report of the STFM Task Force on Training Residents for the Future). Fam Med 1986; 18: 29–37.PubMedGoogle Scholar
  13. 13.
    McWhinney IR. General practice as an academic discipline. Lan-cet 1966; 1: 419–423.CrossRefGoogle Scholar
  14. 14.
    Donateile EP. In Taylor RB, ed. Family medicine: principles and practice, Ist ed. New York: Springer-Verlag, 1978, p 2.Google Scholar
  15. 15.
    Merit Project. A compendium of topics for curricular development in family practice. Kansas City, MO: Family Health Foundation of America, 1983.Google Scholar
  16. 16.
    Marsland DW, Mayo F, Wood M. A data bank for patient care, curriculum, and research in family practice: 526,196 patient Problems. Part I. rank order of diagnoses by frequency. Part II. diag-noses by disease category and age/sex distribution. J Fam Pract 1976; 3: 38–68.Google Scholar
  17. 17.
    summary national ambulatory medical care survey. Washington, DC. Health Research, Statistics, and Technology No. 66 (DHSS Publication Number PHS 85–1250 ), March 1981.Google Scholar
  18. 18.
    Rosenblatt RA, Cherkin DC, Schneeweiss R, et al. The structure and content of family practice: current status and future trends. J Fam Pract 1982; 15: 681–688.PubMedGoogle Scholar
  19. 19.
    Merkel WT. The family and family medicine: should this marriage be saved? J Fam Pract 1983; 17: 857–862.PubMedGoogle Scholar
  20. 20.
    Beasley JW. A simple measurement of family care in medical practice. J Fam Pract 1985; 21: 70–71.PubMedGoogle Scholar
  21. 21.
    Frank SH. The unit of care revisited. J Fam Pract 1985; 21: 145–148.PubMedGoogle Scholar
  22. 22.
    Medalie JH. Family medicine: principles and applications. Baltimore: Williams & Wilkins, 1978.Google Scholar
  23. 23.
    Duvall EM. Family development, 5th ed. Philadelphia: Lippincott, 1977.Google Scholar
  24. 24.
    Carmichael LP: The family and medicine, process or entity? J Fam Pract 1976; 3: 562–563.PubMedGoogle Scholar
  25. 25.
    Ransom DC, Vandervoort HE. The development of family medicine: problematic trends. JAMA 1973; 225: 1098–1102.PubMedCrossRefGoogle Scholar
  26. 26.
    Taylor RB. Family: a systems approach. Am Fam Phys 1979; 20: 101–104.Google Scholar
  27. 27.
    Swee DE. Family resources. In Taylor RB, ed. Family medicine: principles and practice, 2nd ed. New York: Springer-Verlag, 1983, pp 64–73.Google Scholar
  28. 28.
    Pellegrino ED. The academic viability of family medicine: a triad of challenges. JAMA 1978; 240: 132–135.PubMedCrossRefGoogle Scholar
  29. 29.
    Miller GE. Teaching and learning in medical school. Cambridge, MA: Harvard University Press, 1961.Google Scholar
  30. 30.
    Ravetz JR. Scientific knowledge and its social problems. New York: Oxford University Press, 1971.Google Scholar
  31. 31.
    Parkerson GR, Barr DM, Bass M, et al. Meeting the challenge of research in family medicine: report of the Study Group on Family Medicine Research. J Fam Pract 1982; 14: 105–113.PubMedGoogle Scholar
  32. 32.
    Perkoff GT. The research environment of family medicine. J Fam Pract 1985; 21: 389–393.PubMedGoogle Scholar
  33. 33.
    Udall KS, Prieve MM. Impact of family practice literature of re-cord on other medical literature. J Fam Pract 1985; 21: 397–399.PubMedGoogle Scholar
  34. 34.
    Robertson DL, Stewart TJ. Families and health: a review of clini-cal and research issues for primary care. Fam Pract Res J 1985; 4: 128–150.Google Scholar
  35. 35.
    Congress of Delegates of the American Academy of Family Physicians, Washington, DC, September 1986.Google Scholar
  36. 36.
    Stephens GG. The intellectual basis of family medicine. J Fam Pract 1975; 2: 423–428.PubMedGoogle Scholar
  37. 37.
    Taylor RB. Categories of care in family medicine. Fam Med 1981; 13 (4): 7–9.Google Scholar
  38. 38.
    Balint M. The doctor, his patient and the illness. New York: International Universities Press, Inc., 1964.Google Scholar
  39. 39.
    McWhinney IR. Beyond diagnosis: an approach to the integration of behavioral science and clinical medicine. N Engl J Med 1972; 287: 384–387.PubMedCrossRefGoogle Scholar
  40. 40.
    Dubos R. The mirage of health: Utopia’s progress and Biological Change. New York: Doubleday, 1961.Google Scholar
  41. 41.
    Engel GL. The need for a new medical model: a challenge for biomedicine. Science 1977; 196: 129–136.PubMedCrossRefGoogle Scholar
  42. 42.
    Sloane PD. Comprehensive and continuous care. In Taylor RB, ed. Family medicine: principles and practice, 2nd ed. New York: Springer-Verlag, 1983, p 123.Google Scholar
  43. 43.
    Banahan BF Jr, Banahan BF III. Continuity and attitudinal con-tract. Semin fam med 1981; 2: 88–96.Google Scholar
  44. 44.
    Congress of Delegates of the American Academy of Family Physicians, October 1975.Google Scholar
  45. 45.
    Taylor AD. How to choose a medical specialty. Philadelphia: W.B. Saunders Co., 1986, pp 39–45.Google Scholar
  46. 46.
    Candib LM. What doctors teil about themselves to patients: Impli-cations for intimacy and reciprocity in the relationship. Fam Med 1987; 19 (1): 23–30.PubMedGoogle Scholar
  47. 47.
    Beauchamp TL, Childress JF. Principles of biomedical ethics. New York: Oxford University Press, 1979.Google Scholar
  48. 48.
    Coping, stress and the practicing physician—a Workshop. Annual Scientific Assembly, American Academy of Family Physicians, Atlanta, 1971.Google Scholar
  49. 49.
    Crouch M. Working with one’s own family: another path for professional development. Fam Med 1986; 18: 93–97.PubMedGoogle Scholar
  50. 50.
    Bowen M. Family therapy in clinical practice. New York: Jason Aronson, 1978, pp 337–387, 461–547.Google Scholar
  51. 51.
    Maslow AH. Motivation and personality. New York: Harper & Row, 1954.Google Scholar
  52. 52.
    Rollins BC, Feldman H: Marital satisfaction over the family life cycle. J Marriage Fam 1970; 32: 26–30.Google Scholar
  53. 53.
    Derdyn AP. The physician’s work and marriage. Int J Psychiatry Med 1979; 9: 297–306.CrossRefGoogle Scholar
  54. 54.
    Clements W, Paine P. The family physician’s family. J Fam Pract 1981; 13: 105–112.PubMedGoogle Scholar
  55. 55.
    Levey S, Hesse DD. Bottom line health care. N Engl J Med 1985; 312: 644–646.PubMedCrossRefGoogle Scholar
  56. 56.
    Catlin RF, Bradbury RC, Catlin RJO. Primary care gatekeepers in HMOs. J Fam Pract 1983; 17: 673–678.PubMedGoogle Scholar
  57. 57.
    Noren J, Frazier T, Altman I, DeLozier J. Ambulatory medical care: a comparison of internists and family-general practitioners. N Engl J Med 1980; 302: 11–16.PubMedCrossRefGoogle Scholar
  58. 58.
    Steinwachs DM, Weiner JP, Shapiro S, et al. A comparison of the requirements for primary care physicians in HMOs with projec-tions made by the GMENAC. N Engl J Med 1986; 314: 217–222.PubMedCrossRefGoogle Scholar
  59. 59.
    Summary report of the Graduate Medical Education National Ad-visory Committee. US Department of Health and Human Services publication (HRA) 81–651. Office of Graduate Medical Education, Health Resources Administration, September 1980, Vol 1.Google Scholar
  60. 60.
    Aiken LH, Lewis CE, Craig J, et al. The contributions of special-ists to the delivery of primary care: a new perspective. N Engl J Med 1979; 300: 1363–1367.PubMedCrossRefGoogle Scholar
  61. 61.
    McCormally T. Döing obstetrics: risky business. Fam Pract News 1984; April 1: 12.Google Scholar
  62. 62.
    Roemer MI. A world perspective on health care in the twentieth Century. J Public Health Policy 1980; 1: 370–379.PubMedCrossRefGoogle Scholar
  63. 63.
    Starr P. The social transformation of American medicine. New York: Basic Books, 1982, p 449.Google Scholar
  64. 64.
    Geyman JP. Training primary care physicians for the 2Ist Century. JAMA 1986; 255: 2631–2635.PubMedCrossRefGoogle Scholar
  65. 65.
    Ostergaard DO. Career alternatives. In Taylor RB, ed. Family medicine: principles and practice, 2nd ed. New York: Springer- Verlag, 1983, pp 1741–1749.Google Scholar
  66. 1.
    The Discipline, the Specialty, the Physician 13Google Scholar

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© Springer Science+Business Media New York 1988

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  • Robert B. Taylor

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