Abstract
Family medicine has grown as a specialty from its early days of general practice. It was established as a Board Certified specialty in 1969. This growth and maturation can be traced in the philosophy of family medicine as articulated by Edmund D. Pellegrino, M.D. Long before it was popular to do so, Pellegrino supported the development of family medicine. In this essay I examine the development of Pellegrino’s philosophical thought about family practice, and contrast it to other thinkers like Ian McWhinney, Kerr White, Walter Spitzer, Donald Ransom, and Hebert Vandervoort. The arguments focus on whether the goals of family medicine and family practice (possibly two distinct entities) can be articulated, especially considering the definitional problems of “family” and “community.” I conclude by echoing Pellegrino’s hope that family medicine can contribute a fresh alternative to isolated, individualistic and technological thinking in medicine.
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References
A good summary of these commission reports may be found in Pellegrino ED. Family practice facing the twenty-first century: reflections of an outsider. Marriage Fam Rev 1987; 10 (3–4): 23–50.
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Primary care includes not only those services that are provided at first contact between the patient and the health professional but also responsibility for promotion and maintenance of health and for complete and continuous care of the individual including referral when required.“ (Ontario Ministry of Health: Report of the Health Planning Task Force, Toronto, 1974, p. 27; quoted in Spitzer WO. The intellectual worthiness of family medicine. Pharos 1977; 40(3): 2–12) See also Starfield B. Primary Care: Concept, Education, and Policy. New York: Oxford University Press, 1992.
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For an example of a detailed effort to relate the humanistic content of family medicine to its scientific and clinical methods, see Levenstein JH, McCracken EC, McWhinney IR, et al. The patient-centered clinical method. 1. a model for the doctor-patient interaction in family medicine. Fam Pract 1986; 3: 24–30. See also Brody H. The Healer’s Power. New Haven: Yale University Press, 1992: 11 65, on why primary care has an ethical basis which is not shared by other specialties.
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Ibid.
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Brody, H. (1997). Edmund D. Pellegrino’s Philosophy of Family Practice. In: Thomasma, D.C. (eds) The Influence of Edmund D. Pellegrino’s Philosophy of Medicine. Springer, Dordrecht. https://doi.org/10.1007/978-94-017-3364-9_2
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DOI: https://doi.org/10.1007/978-94-017-3364-9_2
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